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MINUTES - 07242001 - C.13
I/ 13 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNLA BOARD ACT10July 24, 2001 Claim Against the County, or District Governed by ) the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document mailed to you is your California Government Codes. ► notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given my-cm—awls, pursuant to Government Code Section 913 and ��JJ 915.4. Please note all "Warnings". JUN 2 5 2U0� - AMOUN'T': Unknown COUNTY COUNSEL CLAIMANT: Robert Lee Wiley MARTINEZ CALIF. ATTORNEY: Arnold Laub DATE RECEIVED: June 20, 2001 ADDRESS: 807 Montgomery St BY DELIVERY TO CLERK ON: June 20, 2001 San Francisco, CA 94133 BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN-SWEETET4, � ler ' . _ Dated: June 22,_ 2001 .By: Deputy_. 11. FROM: County Counsel TO: Clerk of the Board of Supervisors ( This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). I ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: 02 3 of By: Deputy County Counsel M. FROM Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 91 ].3). IV. BOARD ORDER: By unanimous vote of the Supervisors present: ( ) This Claim is rejected in full. (, ) Other: I certif that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: i u / JOHN SWEETEiV Clerk, By I putt' Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6, You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF INIAII:ING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: l By: JOHN SWEETEN, CLERK By 1�— Deputy Clerk LAW OFFICES Of ARNOLD LAUB A PROFESSIONAL CORPORATION CORPORATE HEADQUARTERS • THE LAUB BUILDING 807 Montgomery Strect • San Francisco, CA 94133 RECEIVED JUN 2 0 200 June 19, 2001 CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. T: 925/335-1900 CLERK OF THE BOARD OF SUPERVISORS COUNTY OF CONTRA COSTA 651 Pine Street, Room 106 Martinez, CA 94553 Re: Our Client: ROBERT LEE WILEY Date of Accident: March 24, 2001 Subject: GOVERNMENT CLAIM Dear Sir/Madam: Enclosed herewith please find an original and copy of a GOVERNMENT CLAIM against the County of Contra Costa regarding the above-referenced matter. Please stamp your acknowledgment of receipt on the enclosed copy and return it to us in the attached self-addressed, stamped envelope. Please do not hesitate to call me if you have any questions regarding the enclosed document. Our toll-free telephone number is 800/338.5282 Ext. 220. Thank you kindly for your assistance and cooperation in this matter. Very truly yours, AW O FIC OF ARN LAUB A Pr tonal porati n Pa ' e Auwbrey, Paralega to James B. LeBow, Esq. PA:P Enclosures as stated cc: Mr. Robert Wiley w/enols. Tel: 4.15/362-0101 • Fax: 415/296-8841 • E-Mail: alaub@laub.com • Web Page: www.laub.com SAN JOSE: 111 West Saint John,Suite 770,San Jose,CA 95113 • 408/297-5060 • Fax: 408/288-5191 Stas Of C almorlea c Board of ton,W -GOVERNMENT SBO(-GC-0002(Rev.5/98) Please and"Onstimcflons for Filing a Claim" If you are filing this claim beyond six months from the incident date, please see instructions for filing a late claim application on the oppo- site page. ,. 7,r! d... .. :.h r• ,.. .. .,- +.. .m.,i!s�r...... .- .._. ..::i _. ?.?; ..:i „„cF.. .ti::r _ ';..}rl'.. >N,::: -M. •�.:y �,r.i 3.. S, .._ .. .',i:. 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Y;'i':' - •k�t'x.':^-.�.T'" . ,. ., .t �, sew,, -'arts .' 5r"G .... .z. ,.... .. ..t"�•....._-.:.-,..r ... .. .. .�.._ r;F�':; k:�;` - _ ��t ,.5,._..__s ..�"...�3�..�,•..,.�>+_--.....,._�..._.,�_ .s................i_.._...�.u.. .•......,..:....,,.......,-,.....:..,:,::,.._..r,..:.. :..n,;.:.�...,x,... _.........._,....L........,.. .._:'='�3.'v ;-.s^!�,c,. .�_.._$:<:,..,..,.�tip':...._ '4 Flame of Claimant Telephone Number (include area code) ROBERT LEE WILEY (510) 223-1110 Mailing Address 2724 Sheldon Court City Richmond State CA Zip Code 94803 :t . 5I:r•k's �'.. S,r.•y x�• 'dlf'v.��• .r,-t,,-.. n�'•,�`T�La'.•e..w�yRY?T:!'r=' �LLeyi."w,,�•:• n\rvv ��'�.`. 1.. h...!{, s+.stra ®;.,•�:,�•, ..�Yr..r'r 4.:�' •.�:; ;:,} ;iw."f,�x!�..�'�yt= �,,� �-. fue:•.r� t�`"'� a..' :;., < ' � ,.,. . s'-'i. � 11�.'H�<.-3.*•�:m.?� .-� ,. .:..ate, ,•'�`:�'.,, .i _ ..��'� -E.. ...':.^+4..,•.- Y'�'Y' 'd.'r1M,L� d' r.........rJ,:,.., *.r ...<::;:5.. .sr_;r,,�,;:;,. �r ;'!�::. ,::x?,,...�.,.. r,.,...- ,.?�c t���-r -•�s fi ::-� �C . .rI)®�.�•�D�r)�,9rIt�e ®aa :., : ..�.'. .. ,:. .: ��_.. I. �5.:�; :�,, :-,� ;:�_;._ :L. _ .R uC.. � .'4��: ::.\Yv`'e"$?.v.. _ :I":'E•��.,.:: 1,•,.Ii. Lr r 1... .-�'�--. h,-�. r.. ..4:.'., .. •,��.'{,l::.J�':r;::...rl':..:KS.:_ _.'�:�• .'.^3fV) `;N': �d:��`rtib'.. ".1n. rJk� ���:. .5�_:�".r.l 1`' n7,kf., is- >�•�r-4.. :�M.-: - ._�tq.,�y�".Y r Avl?'ek?3:...�:= rx.. .0.: ��',.,-A:.�{`+E. �.K.F,..f._ F'�...,� �.,rt- t:a:r�'�sti. ..,.' -=�• .i�• :"v'. .�.,�i .'l'. .'.V..n S�" ..,E rr:,... .�,.,J, ,��. 3. �� :^.t .-a,.. Name of Public Agency against which this claim is filed Incident Date i®ollar Amount of Claim CONTRA COSTA COUNTY CONLMUNITY SERVICES I^`Month 3 Day 24 Yr O1 - $l , 500, 000 .00 If the amount exceeds $10,000, check the appropriate court I Explain how the dollar.amount claimed was computed. (Attach of jurisdiction: Municipal Court Superior Court three copies of the supporting documentation for the amount claimed with this form.) _ Describe the specific damage or injury incurred as a result of SEE EXHIBIT "Q." ATTACHED HERETO. the incident: SEE EXH_ IBIT "A" ATTACHED HERETO._ .Location of the incident (If applicable, include street address, city or county, highway number, post mile number and direction of travel.) SEE EXHIBIT "D" ATTACHED HERETO. • i Explain the circumstances that led to the alleged damage or injury. State all facts that support your claim against the State of California, and why you believe the State is responsible for the alleged damage,or injury. If known, provide the name(s)of the State employee(s) who allegedly caused the injury, damage or loss. (If more space is needed, please attach additional sheets.) SEE EXHIBIT "B" ATTACHED HFRFT0_ staff of cuafc `emco • Submit completed claim form and . mrd of Colmf1®I three copies to: ENCLDIGOVERNMENT CLAIM STATE BOARD AIMS WSION SBO(-G(-0002 (Rev. 5/98) Reverse P.O.Box 3035 Sia ,A 958 1 2.3035 a 0 3. a �G k T n: r: - :T e. ,�r [ •<•' �:- •I• ;It:clt3tit�-.inv ves;tn�t®r.., eb cue�.�• x ...rF:-.'_fir:�; 3 � tc �a = rE r + b�rlJ�e- � I .e Fa ; '; :';:.... . Has the claim for the alleged damage/injury been filed Name of insurance carrier iTelephone number (include area code) or will it be filed with your insurance carrier? Iles Q Pio Mailing Address- City Statep Zi Code Policy Number - -- Amount of Deductible Are you the registered owner? _J Yes J No_ ~9Uiahe: Model: Year: ,...t. ..._.r...............:...._ . . :qtr.:. :! le m. :b. -tl a State°'`a'en' resenfi 'claim F �. �'���:,:: jmk--:. must.be3 �,....:. ...... .:.. :.:..r_. :x.:, i d et..Act: ro rs®Bois>o:ItemMunibe;®ridffe® ro'raafi�:,.:... ea. -r. ,,r.; : ,....,t..::,.: .; :.•,. ,.x., .9: ,AP.P p _ - _ PP.; , ..4. ... ._.. .. -�,.. ..... ... -.i.... ,�.: ... .. a.a .. .T .. .... .. .. .. .. 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W. _ ��6�0�D8•��. a Zen . must'&e'completed if clusm;is being f':led 5y gn ntforney=o>gutliorized:representative.)�n; ':„'�:..• M, Name '. ;><...• - [ � '1:_ 'L! Name of Attorney/Representative Telephone umber(include area(ode) JAMES B. LeBOW, ESQ. �(SBN # 196334) LAW OFFICES OF. ARNOLD L_ AUB-,. APC (415) 362=0101 Ext. 205 ---� tit - State � Zi Mailing Address. y p 807 Montgomery Street San Francisco, CA 94133 :.....:. ... 4, Pi •. ..... .... Rig , 4 f'- :. ,fir [ � ,.. .... .^...... .... ...:..s,..... .... ., C.__:. � rit _ �1 r,� �{>+ L. ty,at yam..:.. .. .. r ._. , .,. .- ':-. .•... ..,:: :�. ':ri�:•::.::�1' ���Ytt t,uta[I 9Vo k1�1���E'ei.�t�U;;�t.�,i1 a Section 72 of rhe Penal Carte provides that`every persoi;1'Iha;'tVITI?intent to defraud,presents for allovivancc or for poyment to.any State Poard or Officer,or to may count),town,city, district, vara or village, hoard of officer, authorized .o olia�d ��r i)a�; elle same if gcnuir e, any false or fraudulent claim, bill, account, voucher, or writing, is guilty of a felony.” — Signature of(lGimant - -_ — abate V Osie - Signature of.Attorney/Representative --J- E B B. Le BOW, ESO. - 6/13/01 GOVERNMENT CLAIM AGAINST: CONTRA COSTA COUNTY COMMUNITY SERVICES BY CLAIMANT: ROBERT LEE WILEY DATED: June 13, 2001 EXHIBIT"A" SECTION 2: CLAIM INFORMATION Describe the specific damage or injury incurred as a result of the incident. As a result of the occurrence, Mr. Wiley was caused to fall, with great force onto the flight of stairs, striking his back against the edge of several stairs and impacting his buttocks on the width of a stair. Upon falling,he immediately felt sharp and severe pain in his back and buttocks. The pain then began to radiate from his lower back to his buttocks and down his legs. At times, he feels a tingling type of numbness in his right foot; he also experiences weakness, numbness and feels constant pain in his lower back, which is aggravated on movement. The pain is also aggravated by either standing or sitting in one position for too long. His ability to work is effected. He feels pain in the lower back which radiates down his legs whenever he exerts himself during walking. He is aware of pain on bending, either forward and backward, or from side to side. Mr. Wiley has presently been diagnosed clinically with a lumbar strain and sprain and back contusions. He has not yet been given an MRI or a CT-scan. Presently,his prognosis is guarded and is being seen to rule out a herniated or protruding, vertebral disc injury with spinal nerve impingement. EXHIBIT"A" GOVERNMENT CLAIM AGAINST: CONTRA COSTA COUNTY COMMUNITY SERVICES BY CLAIMANT: ROBERT LEE WILEY DATED: June 13, 2001 EXHIBIT"B" SECTION 2: CLAIM INFORMATION Explain the circumstances that led to the alleged damage or injury. State all facts that support your claim against the State of California, and why you believe the State is responsible for the alleged damage, or injury. If known, provide the name(s) of the State employee(s) who allegedly caused the injury, damage or loss. (If more space is needed, please attach additional sheets). On or about March 24, 2001, Mr. Robert Wiley was receiving court- ordered,residential, substance abuse treatment at the DISCOVERY HOUSE, a treatment center owned and operated by CONTRA COSTA COUNTY. Mr.Wiley had been staying at the facility, an apparently two-story, wood-framed house, for approximately three weeks prior to the occurrence. While descending the exterior staircase, which leads from the second story to the first, and is the primary means of ingress and egress for those treatment residents whose assigned living quarters are on the second floor, one or more of the wooden stairs of which the staircase was constructed, or a portion of the stairs, suddenly gave way under Mr. Wiley's feet, fracturing, splintering and breaking, causing him to fall. He landed upon the remaining portion of the staircase. He landed with great force upon his buttocks, back and legs. The occurrence was caused and is the direct result of the negligence of CONTRA COSTA COUNTY in its ownership,operation, control, maintenance,inspection and construction of the staircase, in that the staircase was constructed of wood and at the time of the incident, the steps, specifically those that gave way under Mr. Wiley,were in a rotted, decreped, weakened condition that were not properly reinforce and were missing surface tread and nosing. The stairs in particular, and the staircase in general,was in such a condition for a period of time, sufficient that the COUNTY OF CONTRA COSTA, its agents, servants and employees, knew or should have known of the dangerous,hazardous condition that is presented to those climbing or descending the staircase. EXHIBIT"B" GOVERNMENT CLAIM OF AGAINST: CONTRA COSTA COUNTY COMMUNITY SERVICES BY.CLAIMANT: ROBERT LEE WILEY DATED: June 13, 2001. EXHIBIT"C" SECTION 2: CLAIM INFORMATION Explain how the dollar amount claimed was computed. (Attach three copies of the supporting documentation for the amount claimed with this form.) The dollar amount loss stated is based upon a claim that Claimant has suffered a herniated disc in his lumbar spine that will require a future laminectomy with rehabilitation. Future medical expenses,including hospital, physicans, physical therapy, pharmaceutical and medical equipment are estimated at approximately...........................$275,000 Loss of future earning capacity: Mr. Wiley is 36-years-old,with a limited education; past work experience and training has been in the area of heavy labor; based upon work expectancy of thirty (30) years, the estimated loss of future earning capacity is approximately................................................ $600,000 Past pain and suffering is estimated at approximately........................................................$225,000 Future pain and suffering is estimated at approximately....................................................$400,000 TOTAL...........................................................$1,500,000 EXHIBIT"C" GOVERNMENT CLAIM AGAINST: CONTRA COSTA COUNTY COMMUNITY SERVICES BY CLAIMANT: ROBERT LEE WILEY DATED: June 13, 2001 EXHIBIT"D" SECTION 2: CLAIM INFORMATION Location of the incident. (If applicable, include street address, city or county, highway number, post mile number and direction of travel.) The incident occurred in Martinez, California, on the premises known as 4639 Pacheco Boulevard. At the time of the incident, the premises was used as a substance abuse, treatment center known as DISCOVERY HOUSE. The incident occurred on an exterior stairway attached to the premises,on the 4`h and 5`h stairs from the top landing of the staircase. (See photographs attached hereto as EXHIBIT"E"). EXHIBIT"D" State of cuffibr tai® 96ard®f c®nG GOVERNMENT CLAIM SBOC-GC-0002(Rev.5/98) Please ream"OnstrattcHons f6r Filing a Claim" If you are filing this claim beyond six months from the incident date, please see instructions for filing a late claim application on the oppo- site page. .. .. ... ... ......._ i . : i .. .... .a a .::.i:..:,:'.".:.. - - .:.y:.r.je: :L•�•:_.,..:::iMe.:,. Name of Claimant Telephone Number (include area code) ROBERT LEE WILEY (510) 223-1110 Mailing Address 2724 Sheldon Court City Richmond State CA Zip Code 9480 a. 1 .. .......... . ...:....:.........:. _ ,. .5 :. . ............ ... ....... :..::�...�.." •':Fid :..�::x'e•. k _ 4 •..............: ...t.. ...._......t. _.. ..__..... .... t ... ,. .. ... .,.... _....... .,....-. ..N ..... .... �,.1:•5'.._ •_:.. l.. ,.i,'>,�.ti,v':�i!i:.�.:J`:':J .M '.Y Name of Public Ageircy against which this claim is filed Incident Date Dollar Amount of Claim CONTRA' COSTA COUNTY COMMUNITY_SERV ICES Month 3 Day 24 yr 01 $1 ; 500 , 000 . 00 If the amount exceeds $10,000, check the appropriate court Explain how the dollar amount claimed was computed. (Attach of jurisdiction: Municipal Court. Superior Court three copies of the supporting documentation for the amount claimed with this form.) Describe the specific damage or injury incurred as a result of SEE EXHIBIT "a." ATTACHED HERETO. the incident. SEE EXHIBIT "A" ATTACHBIL HERETO. Location of the incident (If applicable, include street address, city or county, i highway number, post mile number and direction of travel.) - I — SEE EXHIBIT "D" ATTACHED HERETO: I Explain the circumstances that led to the alleged damage or injury. State all facts that support your claim against the State of California; and why you believe the State is responsible for the alleged damage, or injury. If known,provide the names) of the State employee(s) who allegedly caused the injury, damage or loss. (If more space is needed, please attach additional sheets.) __ _ SEE EXHIBIT "B". ATTACHFD HFRFTn, _ as' «1,rry Slate'of Calierneli Submit completed claim form and &mrd of Control three copies to: STATE BOAR®OF CONTROL G"OVERNMENTLAOLARM GOVERNMENT CLAIMS DWISION SBOC-GC-0002 (Rev. 5/98) Reverse P.C.Boac 3M5 Sacramento,CA 95832-3035 - _ :NO:TI�'A'PIP:L - ,. ,,.:' : '' ,. rpl. �.....;!'.�=, ,.. : ' t .:-'.4. �•,•.... - I �, ::rt.I��Fp . 1 . .,S.:i��tt3f'.U2 -.I:Gp;B�i,'E>� - - Has the doirn for fire alleged damage,Anjur; been filed Jimame of insurance carrier Teiephone number(include area code) or will it he filed with your insurance carrier; Yes Lj No — — - -- --- Mailing Address - ------ City State Zip Cade 'Policy Number - Amount of Oeductibie i Are you the.registered owner? D Yes U No Make: --- - - Model: Year: r � ..,;. . ... es 5_ate..agen--Y:..F,....-..._...:.9;c.....,r:.1,< r � ,.. ,.. . .. _ .. ... r.. ,.._, i..:.., rid et::Act'=.p;: �®r:¢i®teia�®� &te�n�i�Jgj;aa�er•.®ai lie�® .r.� ...e•1. ... .. :_ .. .... .... i.. .r..�.4c:.lr -.I. .twy - .:4.:..a�. a j:a":t.''_ }�� iq .. r .. ... .r ....r ..... ._._...... : - Y. .,._ F ..... ._ P. .. ... a .... .. -.i... .. 1 SJT L.I C. LiJ ..., ..:.:•. Cr•.....I .. .,......._ ........ ... ........... .....i.,._ ....- .. ,... .._.. .... ...,_. ,.�-.. - - 'rive;::� ... ..r...[,.. n M1,... ....:r...,.. .....tar._.. ..:J. - - ,:•I.r:4 •utr a:r;,�,,:..,:,':.:;:[u:;,...'.,:>.:;; . I<9�nte 10$ a enc b e➢ et.offac$ . Ir r e t. t ve. _ .... .:. .,r.:.:,:->:=..:�:+: ... .c, ..n... ...-f. .. : .. .. .. .. ...:.. 1 - - .r.G ..,... . . ... .: ... ... ,ham._ ..... . ._.. .,,. . ... .. .. - ... ......1-.\...:....-.. ,. .: .. ....:.-_ •.�:..,... _ • r � rr v. :. :. .. -...:..... ...r aS ....:c...::::.:.:...:': : :•':!..:•r��:.... , ...._...r.:;':a:i'4=:..>•...:.:.....:.. te..._,t. .....:,:::.�'::.":':i'..;,.':.i•:e1::.;�r-,• ,.'<,::I :•1: .. K Da .Sr rrnture:.o�_a enc •:,bud et;.af$rcer.,.or-{re reserrtntrve.:... , .'!.:-t:. ..:...:..... :'. - - Y - ! ..... .,_ .. ..... ...............: .:::v:>:.,.::.: fry).�.'f•<'!�r �:�i'��1:•"l�.'�L .. ... r ... :.. .. ... •... •. ..,... .. .., ..:�. _ ".(".?ii.a..�.;t::;.�,�:��•.';�:,�iy`1 ic'i'ly' , r.. Sig ......:: 1, r r .. .... ... .. • I '::' ',.. . fifl'�:- muni e:corp etp. ;c:;c�am:is.:�eng- i ec�_yangtforney;nr':;auf„oro�egrepresenr6ri�e+�;; ::; E�ame o(Attorney/Representative � - � -��I- iereplrone �urr:ber Imclude area code)-.� JAMES B. LeBOW; ESQ. (SBN # 1963.34) � F415) 362-0101 Ext. 205 LAW OFFICES OF. ARNOLD LAUB,. — i 6'£railing Address Citg^ State Zip 807 Montgomery Street San Francisco, CA 94133 .......:.. U ti .._ ...... ...... : ., :.,I,. :.�r� ,....— .r :. r•r,,..,... 1,. '•:� ilr�—:,II! (;�Ir '(iii!, .,I ... -:1 .. . ..li :i'.,,. . .r..�_.. ..r ..F.I. .r .., ..! L<,<•I,i':r `Ol'1i1,ilT`:�. :SII+J�' ._ ...! .!ill. ..il.:'!: .:'!1:.. :, :'�:�l=;l'' i)�;I;:lir I":ilii• �.lii i; �li�;' l.' �iiri /, i{ ; !I,,.. M !!�.'.. ,ln .rrl�; ,.,f,: :.r.. . .. r,.�.. 'I..I rl' — ,jar.• '(: i"j" !i l; „ i.ii lu �!:; lid j! .i iiilj il; :ii�jl'•'', '! �i ii!i ':11.;i' Ililfl:, :i: �I ,. is iimili''i of 6 1 JA�'iE B. LeBOt��, ESO. � 3./O1 r � GOVERNMENT CLAIM AGAINST: CONTRA COSTA COUNTY COMMUNITY SERVICES BY CLAIMANT: ROBERT LEE WILEY DATED: June 13, 2001 EXHIBIT"A" SECTION 2: CLAIM INFORMATION Describe the specific damage or injury incurred as a result of the incident. As a result of the occurrence, Mr.Wiley was caused to fall, with great force onto the flight of stairs, striking his back against the edge of several stairs and impacting his buttocks on the width of a stair. Upon falling, he immediately felt sharp and severe pain in his back and buttocks. The pain then began to radiate from his lower back to his buttocks and down his legs. At times, he feels a tingling type of numbness in his right foot; lie also experiences weakness, numbness and feels constant pain in his lower back, which is aggravated on movement. Th.e pain is also aggravated by either standing or sitting in one position for too long. His ability to work is effected. He feels pain in the lower back which radiates down his legs whenever he exerts himself during walking. He is aware of pain on bending, either forward and backward, or from side to side. Mr. Wiley has presently been diagnosed clinically with a lumbar strain and sprain and back contusions. He has not yet been given an MRI or a CT-scan. Presently, his prognosis is guarded and is being seen to rule out a herniated or protruding, vertebra( disc injury with spinal nerve impingement. EXHIBIT"A" GOVERNMENT CLAIM AGAINST: CONTRA COSTA COUNTY COMMUNITY SERVICES BY CLAIMANT: ROBERT LEE WILEY DATED: June 13, 2001 EXHIBIT"B" SECTION 2: CLAIM INFORMATION Explain the circumstances that led to the alleged damage or injury. State all facts that support your claim against the State of California, and why you believe the State is responsible for the alleged damage, or injury. If known, provide the name(s) of the State employee(s) who allegedly caused the injury, damage or loss. (If more space is needed,.please attach additional sheets). On or about March 24, 2001, Mr. Robert Wiley was receiving court- ordered, residential, substance abuse treatment at the DISCOVERY HOUSE, a treatment center owned and operated by CONTRA COSTA COUNTY. Mr. Wiley had been staying at the facility, an apparently two-story, wood-framed house, for approximately three weeks prior to the occurrence. While descending the exterior staircase, which leads from the second story to the first, and is the primary means of in"ess and egress for those treatment residents whose assigned living quarters are on the second floor, one or more of the wooden stairs of which the staircase was constructed, or a portion of the stairs, suddenly gave way under Mr. Wiley's feet, fracturing, splintering and breaking, causing him to fall. He landed upon the remaining portion of the staircase. He landed with.great force upon his buttocks, back and legs. The occurrence was caused and is the direct result of the negligence of CONTRA COSTA COUNTY in its ownership, operation, control,maintenance, inspection and construction of the staircase, in that the staircase was constructed of wood and at the time of the incident, the steps, specifically those that gave way under Mr.Wiley, were in a rotted, decreped, weakened condition that were not properly reinforce and were missing surface tread and nosing. The stairs in particular, and the staircase in general,was in such a condition for a period of time, sufficient that the COUNTY OF CONTRA COSTA, its agents, servants and employees, knew or should have known of the dangerous, hazardous condition that is presented to those climbing or descending the staircase. EXHIBIT"B" GOVERNMENT CLAIM OF AGAINST: CONTRA COSTA COUNTY COMMUNITY SERVICES BY CLAIMANT: ROBERT LEE WILEY DATED: June 13,2001 EXHIBIT"C" SECTION 2: CLAIM INFORMATION Explain how the dollar amount claimed was computed. (Attach three copies of the supporting documentation for the amount claimed with this form.) The dollar amount loss stated is based upon a claim that Claimant has suffered a herniated disc in his lumbar spine that will require a future laminectomy with rehabilitation. Future medical expenses, including hospital, physicans, physical therapy, pharmaceutical and medical equipment are estimated at approximately...........................$275,000 Loss of future earning capacity: Mr. Wiley is 36-years-old,with a limited education; past work experience and training has been in the area of heavy labor; based upon work expectancy of thirty (30) years, the estimated loss of future earning capacity is approximately................................................ $600,000 Past pain and suffering is estimated at approximately........................................................$225,000 Future pain and suffering is estimated at approximately....................................................$400,000 TOTAL...........................................................$1,500,000 EXHIBIT"C" GOVERNMENT CLAIM AGAINST: CONTRA COSTA COUNTY COMMUNITY SERVICES BY CLAIMANT: ROBERT LEE WILEY DATED: June 13,2001 EXHIBIT"D" SECTION 2: CLAIM INFORMATION Location of the incident. (If applicable, include street address, city or county, highway number, post mile number and direction of travel.) The incident occurred in Martinez, California, on the premises known as 4639 Pacheco Boulevard. At the time of the incident, the premises was used as a substance abuse, treatment center known as DISCOVERY HOUSE. The incident occurred on an exterior stairway attached to the premises, on the 4"' and 5`h stairs from the top landing of the staircase. (See photographs attached hereto as EXHIBIT"E"). EXHIBIT"D" ... � � ® 0 @ O *PA . V 0 JA . ¥ K � f # 'a . .� 2 a « ® ƒ Q c > S & > % ¥ , o $ ® o & - � \ � � Q J $ e \ / / < / cr, C �3 CLADI BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFOR>yLA BOARD ACTION .jTWy ,�24. 2001 Claim Against the County, or District Governed by the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document mailed to you is your California Government Codes. I notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given pursuant to Government Code Section 913 and R1Eq;1HZ1Vt$A Please note all "Warnings". AMOUNT: Unknown C,"' :1!GQ MX-,i�1AEZ LALI jN 2 5 20� CLAIMANT: Edwardo C. Martinez COUNTYCOUNSEI. MARTI.N[;-..z CALIF. ATTORNEY: None DATE-RECEIVED: June 21., 2001 ADDRESS: 4509 Fly_ Ln. BY DELIVERY TO CLERK ON: June 21, 2001 Oakley, Ca 94561 BY MAIL POSTMARKED: I. FROIVL• Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. s J VET Ni, C e k Dated: June 22, 2001V — By: Deputy. H. FROM County Counsel TO: Clerk of the Board of Supervisors ( his claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). I ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.0. ( ) Other: Dated: By: Deputy County Counsel III. FRO;1 Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present: This Claim is rejected in full. Other: I certif that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: JOHN SWEETEN Clerk, By ' ameputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 935.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF 1VIA11JNG I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. By. JOHN SWEETEN CLERK Dated: B By_�ttJt'06 Deputy Clerk I C�:laizu to: BOARD OF SUPERVISORS OF CONTRA COSTA COUN4ARON HYMES-OFFORD INSTRUCTIONS TO CLAMANT JUN 2..1 Z001 �►. . Claims Msfma to causes of action.for death or.for injury to personae to personal property or growing crops mast be re'eatzd not Luer:than the 100 day:after the and which accrue on or before December 31, 1987, . p i° accrual of the cause.of,action CLrims•relating to causes or of action for death" for.injury to person'or.to personal propem:or growing crops,and which accrue on or after January,1, 1988,must bepresented not:later than six months after the accrual of the carie of action. Claims'relating to any other cause of action must be. presented not later than one year;after the accrual of the cause of action. (Govt. Code§911.2.) B. Claims must be filed with the Clerk of the Board..of Supervisors at its office in:Room 106, County Administration Building,651 Pine Street.Martinez,CA 94551.. : _.-. . ... ._ ....... C. U Claim is against a district governed by the Board of Supervisors; rather than the County, the name of the District should be filled in. D.. If the cl6m is against-more.thou one pubfic:entitY,separate.claims must be filed against each.public entity. E Fraud. See penalty for fraudulent claims. Penal Code Set:.72.at the end of..this form: RE: Claim by Reserved for Clerk's.Filing Stamp l _ RECEIVE® 4rai6sc the County of Contra Costa JUN 2 12001 or CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. District) (Fill in Name) The undersigned claimant hereby.makes claim against the County of Contra Costa.or the above named District in the sum of S and in support of this claim represents as follows: 1. When did the damage or injury.occur? Give exact Date-and Hour) ----( = ------------------------------------------------------------------- . _. Where did the damage or injure•occur' (include City and County t ----- -.------------------------ . . 3. Hotir did the damage or iujurv-occur:: .. .(Giv.Edl deeadr.use extra paper it.required:i . �T GtlAa Pr9lvit O +✓ CO w✓ 1y. y ;�0 f,. Ct t0O wr '�/.' y:5. ��.. � , ��, y'-<----A- G'-A-R- -D-�----------------------------- 4. - ------ -- _. .:y ------ j/ -- -- ---- - 4. What particular act or.omission on the part of county or district officers, servants, or employees caused the injury or damage? .Z T'. l t1.A o. / (Over) ::. . _tj I \':.' �: :•: �:. ice,;:.;:;,..J}•,- _, ii.. iY zt IT .'t,vE- ,. , ..._..:J.r•.t.�itir,s':�'' ::4?K=`,-y> °an7t�'� ., �I_i�. Y�' �:r Jae ..._ ,.• 1�p -'•'e a4 ,'•:' - >1 --.... .... ... .::• i • F,a •i- J — rl _i it ;IF,;,j.: �r <�� �;ir` _ � \,,e' -- — 4..t4 V.•� i n � . r "I I .ti : of - I 4 __.e .f .�F.:Y `-.. ..�. �.�;. :a�':ti:r_u�i}d! 1'� •i'tt>ti .0 r '`I'�.'b�l� . , a a . .:L L•v�'' - � '•'F� ����:� - p..: - ;S.-'n „fir-.. ..�Y �.iv� .q�.t •. 1 ••Y I[ '0 9 Y ?h -T 1 I I s ;:-,:ti::...(..,.,:�. ,;.�:��..: •.:�; - -vF-_ ;�.;<'T'+t •�: ytn Y.:}'>�,.. �r:'q•_„y. 'i._' .�'t :�n'.;:.c:...L� I ;•}>_._LpL.” •`•.1,a4•; yy�. - 111, � 4�y -:.1-::.y-j��, ./�:` "-•��. 'y ^��, ..'-r,)'. ,Y`-� :.�' .'�..s:': ,,,.,1•..i., M1'`t�.r-1 t ."�_ •7.-�•:.. •..Y'-_ _ - •'�,{.�>f .�tL ,�3,.f1•• f:/• k•'��::f•:::.r�i:: •:i'=_ .- �:J.,}..�J: ,=j;.1;-.�.:�':r,t•.t '1• .i+•�r '� ,•,A.f:r_1> :.;1iT:��"y'>r}f,'+�'?.:!'-f,7;' .!]'�'l'.;IQ',�a J'•: •14. � �/;J:�A�r.�y t, >�:;•.i y+2�.�� '���"t! 1'.� .1: ''i.'dr, f•f•> -':4'�_.•!�? x.wnt:,-L' .};t'':Ri�" � 'j'a�J>.-.�,y.;;•.>:;��«='�a��:'•�,"r,�.'�i,3ts,J. ..1� 'i_:;:.$ f> ,.s,% __ •'�: ,� �-S;�`t�•.u'.., �kl ! .fir,•. -Ei:t� r_'>.;: ''v"�- :13:! '-.xsy•� 'r� %ix%•: f i? �.�:'ri�4,•.t:i'L'��fj�il? nflTaC� K.4 v'??.�.1:.. :x+.:x;..27'*,_.. —:�i;ti;', ii'` .�� ... '..I `pi�. 1 05/25/2001 at 10:01 AM Job Number: 17163 CASEY'S AUTO BODY License #:AB057216 Quality is our Number 1 Concern 4515 O'Hara Brentwood, CA 94513 (925)634-2211 Fax: (925)634-7257 PRELIMINARY ESTIMATE Written by: Mark Casey # Adjuster: Insured: EDWARD MARTINEZ Claim # Owner: EDWARD MARTINEZ Policy # Address: Deductible: Date of Loss:,: Day: (925)625-1102 Type of Loss: Point of Impact: 7• Left Rear Inspect CASEY'S AUTO BODY Business: (925)634-2211 Location: 4515 O'Hara Brentwood, CA 94513 Insurance Company: Days to Repair 1981 CHEV CAMARO 6-3.8L-2 2D Int: VIN: UNK Lic: Prod Date: Odometer: Clear Coat Paint Power Steering Power Brakes Bucket Seats ------------------------------------------------------------------------------- NO• OP• DESCRIPTION QTY EXT• PRICE LABOR PAINT ------------------------------------------------------------------------------- 1 QUARTER PANEL 2* Rpr LT Outer panel 12.0 2.8 3 Add for Clear Coat 1.1 4 0 Repl LT! Spoiler 1 52.76 0.3 0.3 5 REAR BUMPER 6** Reple RECOND Bumper cover 1 152.00 1.0 1.5 7 Add for Clear Coat 0.6 8# Cover Car 1 5.00 T 0.3 1 ' 05/25/2001 at 10:01 AM Job Number: 17163 PRELIMINARY ESTIMATE 1981 CHEV CAMARO 6-3.8L-2 2D Int: ------------------------------------------------------------------------------- NO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- Subtotals ==> 209.76 13.6 6.3 Parts 204.76 Body Labor 13.6 hrs a $ 60.00/hr 816.00 Paint Labor 6.3 hrs a1 $ 60.00/hr 378.00 Paint Supplies 6.3 hrs .@ $. 28;00/hr 176.40 Sublet/Misc. 5.00 ---------------------------------------------------- SUBTOTAL $ 1580.16 Sales Tax $ 386.16 a 8.0000% 30.89 ---------------------------------------------------- 6RAND TOTAL $ 1611.05 ADJUSTMENTS: Deductible 0.00 ---------------------------------------------------- CUSTOMER PAY $ 0.00 INSURANCE PAY $ 1611.05 This is just an estimate of repairs, if on futher inspection, additional parts br repairs are needed, you .will be contacted for authorization. We are not responsible for loss or damage from fire, theft accidents or causes beyond our control to your vehicle. Storage charges will occur 48 hours after customer is not ified that vehicle is completed. Casey's Auto Body guarantees all repairs performed on your vehicle including parts, workmanship and refinishing for a period of not less than one year from the time of completion of repairs. Defects in craftmanship or refinishing are warranteed for as long as you own your vehicle. 2 05/25/2001 at 10:01 AM Job Number: 17163 PRELIMINARY ESTIMATE 1981 CHEV CAMARO 6-3.8L-2 2D Int: Estimate based on MOTOR CRASH ESTIMATING GUIDE. Unless otherwise noted all items are derived from the Guide D01CD78 Database Date 5/1996 and the parts selected are OEM-parts manufactured by the vehicles Original Equipment Manufacturer. Asterisk W or Double Asterisk (*$) indicates that the parts and/or labor information provided by MOTOR may have been modified or may have come from an alternate data source. Non-Original Equipment Manufacturer aftermarket parts are described as AM or Qual Repl Parts. Used parts are described as LKQ, Qual Recy Parts, RCY, or USED. Reconditioned parts are described as Recon. Recored parts are described as Recore. NAGS Part Numbers and Prices are provided from National Auto Glass Specifications, Inc. Pound sign (#) items indicate manual entries. Pathways - A product of CCC Information Services Inc.. Date: 5/25/01 02:40 PM •, Estimate ID: 2241 Estimate Version: 0 Preliminary Profile ID: CSAA DOM A NTIOCH AUTO BODY, INC . 1401 VERNE ROBERTS CIRCLE ANTIOCH,CA 94509-7915 (925)757-3586 Fax: (925)757-5246 Damage Assessed By: Debbie Benson ESTIMATED BY SERGIO GONZALEZ Deductible: UNKNOWN Insured: EDWARDO MARTINEZ Address: 4509 FIG LANE OAKLEY,CA 94561 Telephone: Work Phone: (925)427-8562 Home Phone: (925)625-1102 Mitchell Service: 914415 Description: 1981 Chevrolet Camaro Body Style: 2D Cpe Drive Train: 3.81-6 Cyl 3A VIN: 1G1AP87A9BL163043 License: 3ETS82S CA Mileage: 171,845 OEMIALT: A Search Code: C94509 Color: WHITE Line Entry Labor Line Item Part Type/ Dollar Labor Item Number Type Operation Description Part Number Amount Units 1 415410 BDY REPAIR L QUARTER OUTER PANEL Existing 7.0*# 2 AUTO REF REFINISH L QUARTER PANEL OUTSIDE 2.9 3 416290 BDY REMOVE/REPLACE L QUARTER SPOILER EXTENSION 339433 GM PART 52.76 0.3 4 AUTO REF REFINISH SPOILER 0.7 5 900500 BDY* REMOVE/INSTALL LFT 1/4 PNL SIDEMOULDING Existing 0.2* 6 417660 BDY REMOVE/INSTALL L COMBINATION LAMP HOUSING Existing 0.5*# 7 AUTO BDY OVERHAUL REAR COVER ASSY 2.2 8 418130 BDY REMOVE/REPLACE REAR BUMPER COVER 14013415 GM PART 181.00 INC 9 AUTO REF REFINISH REAR COVER 2.2 10 936012 ADD'L COST HAZARDOUS WASTE DISPOSAL 2.00 11 933003 REF ADD'L OPR TINT COLOR 0.5* 12 933018 REF ADD'L OPR MASK FOR OVERSPRAY 5.00* 0.1* 13 AUTO ADD'L COST PAINT/MATERIALS 189.00 * -Judgement Item #- Labor Note Applies ESTIMATE RECALL NUMBER: 5/25/01 14:40:37 2241 UltraMate is a Trademark of Mitchell International Mitchell Data Version: APR_01_A Copyright(C)1994-2000 Mitchell International Page 1 of 2 UltraMate Version: 4.6.004 All Rights Reserved 01 Date: 5/25/01 02:40 PM Estimate ID: 2241 Estimate Version: 0 Preliminary Profile ID: CSAA DOM Add'I Labor Sublet I. Labor Subtotals Units Rate Amount' Amount Totals II. Part Replacement Summary Amount Body 10.2 52.00 0.00 -6.R7 530.40 Taxable Parts 233.76 Refinish 6.4 52.00 5.00 0.00 337.80 Parts Adjustments 23.38- Sales Tax @ 8.000% 16.83 Non-Taxable Labor 868.20 Total Replacement Parts Amount 227.21 Labor Summary 16.6 868.20 III. Additional Costs Amount IV. Adjustments Amount Taxable Costs 189.00 Customer Responsibility 0.00 Sales Tax @ 8.000% 15.12 Non-Taxable Costs 2.00 Total Additional Costs 206.12 I. Total Labor: 868.20 II. Total Replacement Parts: 227.21 III. Total Additional Costs: 206.12 Gross Total: 1,301.53 IV. Total Adjustments: 0.00 Net Total: 1,301.53 This is a preliminary estimate. Additional changes to the estimate may be required for the actual repair. Insurance Co: CSAA-DOM WALNUT CREEK,CA 94595 Telephone: (888)350-8900 Body Shop: ANTIOCH AUTO BODY INC. 1401 VERNE ROBERTS CIRCLE ANTIOCH,CA 94509 Telephone: (925)757-3586 Fax Phone: (925)757-5246 **Special Parts Note: All crash parts on this estimate are "New" parts (OEM) unless otherwise specified. Parts described as Rechromed, Recored, or Remanufactured are either "Reconditioned" parts or "Rebuilt" parts. Crash parts described . as "Qual Repl Part" are non-OEM aftermarket parts.** ESTIMATE RECALL NUMBER: 5/25/01 14:40:37 2241 UltraMate is.a Trademark of Mitchell International Mitchell Data Version: APR_01_A Copyright(C)1994-2000 Mitchell International Page 2 of 2 UltraMate Version: 4.6.004 All Rights Reserved C.13 BOARD OF SUPERVISORS OF CONTRA COSTA COLJNTY CALIFORN'LA BOARD AC110July 24, 2001 Claim Against the County, or District Governed by ) the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to 1 The copy of this document mailed to you is your California Government Codes. I notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given (9:1911WMM pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". JUN 2 5 2001 AMOUNT: $10,000 COUNTY COUNSEL CLAIMA'N'T: Courtnee .Turner MARTINEZ CALIF. ATTORNEY: Richard J. Simons DATE RECEIVED: June 22, 2001 ADDRESS: 22274 Main St BY DELIVERY TO CLERK ON: June?,, 2001 Hayward, Ca 94541 BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JO ETEiV, Cl k Dated: June 22, 2001 By: Deputy, i 11. FROM County Counsel TO: Clerk of the Board of Supervisors ( This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). I ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: -o?7—D( By: ` "fi L]_ Deputy County Counsel III. FROM Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to.claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present: This Claim is rejected in full. ( ) Other: I cert' v that this is a true and correct copy of the Board's Order�petered in its minutes f r this date. Dated: C9"l U 1 JOIN SWEETEN Clerk, By � " ' � eputy Clerk WARNING (Gov, code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice, AFFIDAVIT OF NIAH.ING I declare under penalty of perjury:that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: ' a. 19f By; JOHN SWEETEN, CLERK By(� �` � .Deputy Clerk 1 RICHARD J. SIMONS, ESQ. State Bar No. 072676 2 FURTADO,JASPOVICE & SIMONS A Law Corporation 3 22274 Main Street Hayward, CA 94541 RECEIVE® 4 (510) 582-1080 Telephone (510) 582-8254 Facsimile JUN 2 2 2001 5 Attorneys for Claimant CLERK BOARD OF SUPERVISORS 6 COURTNEE TURNER coNTRAcos�Aco. 7 8 BEFORE THE BOARD OF SUPERVISORS OF 9 THE COUNTY OF CONTRA COSTA 10 11 COURTNEE TURNER, NOTICE OF CLAIM 12 (Government Code §910) Claimant, 13 14 TO THE BOARD OF SUPERVISORS OF THE COUNTY OF CONTRA COSTA AND TO 15 THE CLERK AND SECRETARY THEREOF: 16 Claimant COURTNEE TURNER presents the following claim: 17 1. The name and post office address of claimant is as follows: Courtnee Turner, do 18 Furtado, Jaspovice & Simons, A Law Corporation, 22274 Main Street, Hayward, CA 94541. 19 2. All notices regarding this claim should be sent to the address set forth above. 20 3. The occurrence which.gives rise to this claim occurred between October 13, 1999, 21 22 and October 17, 2000, at Contra Costa Regional Medical Center, 2500 Alhambra Avenue, 23 Martinez, California, a health center owned, controlled, and operated by the County of Contra 24 Costa. 25 26 1 NOTICE OF CLAIM iTADO.JASPOVICE & SIMONS LAW COR✓ORATION I 1 4. Between the dates set forth herein, claimant was a patient receiving health care at 2 Contra Costa Regional Medical Center, including health care for obstetric and gynecological issues 3 related to'pregnancy and post-partum care for a delivery of a healthy infant on March 28, 2000. 4 Said birth occurred at Sutter.Delta Medical Center, County of Contra Costa. During the time that 5 she was under the care of agents and employees of the County of Contra Costa and Contra Costa 6 7 Regional Medical Center, claimant developed a breast lump and other signs and symptoms of 8 potential cancer. Respondent County of Contra Costa, acting through its agents and employees, 9 were professionally negligent.in diagnosing, monitoring, assessing, and providing follow-up care 10 and treatment for claimant, and specifically in failing to diagnose and treat, or refer for treatment, 11 the breast lump which claimant presented with and complairied of on July 21, 2000. Respondent 12 County of Contra Costa, acting through its agents and employees, was further negligent in failing to 13 perform adequate physical examinations and testing prior to July 21, 2000, to ascertain the ,14 presence of claimant's breast lump, and to diagnose, assess, and evaluate it, and were further 15 negligent in failing to provide adequate follow-up care, monitoring, and instructions and 16 �7 information to claimant after discovery of the breast lump and other signs and symptoms of possible 18 cancer on July 21, 2000. Claimant's cause of action accrued on or about January 12, 2001, at 19 I which time she was informed by subsequent treating physicians that a mammogram taken on 20 January 12, 2001, was suggestive of malignancy, and that breast cancer may be present. Claimant 21 was advised on or about January 31, 2001, that she had infiltrating ductal carcinoma of the right 22 I breast. 23 j. As a result of the professional negligence of the agents and employees of 24 respondent, acting within the course and scope of their agency and employment, as set forth 25 26 . NOTICE.OF CLAIM .ITADO.JASPOVICE & SIMONS LAW CORPORATION l 1 herein, claimant Courtnee Turner has been.required to undergo extensive invasive medical care 2 and treatment, chemotherapy and radiation, and further suffered an advancement of her breast 3 cancer which has deprived her of the probability of survival of that disease. As further injury and 4 damage, claimant has incurred medical expenses, pain and suffering, and emotional distress, and 5 will incur more such damages in the future. 6 7 6. The names of the agents and employees of the respondent causing the injuries and 8 damages are not known specifically to claimant at this time. 9 7. The amount of this claim exceeds $10,000.00, and jurisdiction of this claim would 10 rest in the Superior Court. 11 8. This.claim is submitted pursuant to Government Code §910, and claimant hereby 12 further advises respondent of her intention to commence legal action based upon the facts set forth 13 - herein, 90 days from the date of this claim, pursuant to C.C.P. §364. 14 Dated: June 19, 2001 FURT O,JASPOVICE & SIMONS 15 aw or oration 16 17 By \ 18 RICHARD J. SIMONS Attorneys for Claimant 19 20 21 22 23 24 25 26 3 NOTICE OF CLAIM RTADO.JASPOVICE & SIMONS k LAW CORPORATION ��) CLAM BOARD QE SUPERVISORSF ' , CALIFORNLA, Z] .!I BOARD A0011b July 24, 2001 JUN 2 6 2001 Claim Against the County, or District Governed by 1 the Board of Supervisors, Routing Endorsements, I COUNT'Cc�u�sE� NOTICE TO CLAIMANT and Board Action. All Section references are to I MARTINEZ,CfilJFcop.y of this document mailed to you is your California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". AMOUNT: $34.65 CLAIMANT: Herman McCoy ATTORNEY: None DATE RECEIVED: June 25, 2001 ADDRESS: 901 Court St. BY DELIVERY TO CLERK ON: June 25, 2001 Martinez, CA 94553 BY MAIL POSTMARKED: June 1, 2001 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JO v'EET J, Clerk ; Dated: June 25, 2001 By: Deputy H. FROM: County Counsel TO: Clerk of the Board of Supervisors ( This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). I ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: �P— a U By: �''% c17Z Deputy County Counsel M. 1FRON1 Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present: (� This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its min �tes�ffothhis date.Dated: JOHClerkN Stiq'EETEN , B} puty Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid certified copy of this Board Order and Notice to Claimant, addressed to the cl imant as 'shown above. lL K �G ' Dated: U�-- �'I�y'��By: JOHN SWEETEN� CLERBy ' L��f� eptity Clerk 11 (5(_�Hl . CL4DII BOARD OF SUPERVISORS OF CALIFORNIA t.. - BOARD ACTIO July 24, 2001 �t JUN! 2 S 2001 Claim Against the County, or District Governed by ) the Board of Supervisors, Routing Endorsements, ) °OI'P14 t*/ ,--i"i`-;_' NOTICE TO CLAIMANT and Board Action, All Section references are to 1 MAPITINEZ. `' h `copy of this document mailed to you is your California Government Codes. I notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below!, given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". AM01,�TT: $34.65 CLAIMANT: Herman McCoy ATTORNTY: None DATE RECEIVED: June 25, 2001 ADDRESS: 901 Court St. BY DELIVERY TO CLERK ON: June 25, 2001 Martinez, CA 94553 BY MAIL POSTMARKED: June 1, 2001 I. FROI`L Clerk of the Board of Supervisors . . TO: County Counsel Attached is a copy of the above-noted claim. JO tiTEETFl1q Clerk Dated: June 25, 2001 By: Deputy j H. FRON1 County Counsel TO: Clerk of the Board of Supervisors ( �. This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). I ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.0. ( ) Other: Dated: 13y: �- ?�eputy County Counsel M. FRONT Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER; By unariiinotis_vote^of.the -Supervisors present: (� This Claim is rejected in full. ( ) Other: I certif that this is a true and correct copy of the Board's Order entered in its min tes for this date. Dated: - 1 � �� ,;� ( JOHN Sy-EETEi3 Clerk, By i _ �i ' � (�' ';ZIIeputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF MAH.EiG I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid._a certified copy of this Board Order and Notice to Claimant, addressed to the claim nt as shown above. / JOHN SWEETEN, CLERK " � ! Dated: � V`-' (-� �- I��J�� Bv: Rv ' (�il:'I-i 1 l�ll`'F-fl/' �� :���TlPniity ('Iwrlr a � r .CC S w w O p w u U 0lamO N /N NA 10 �scddo yo m? W; 6` n vO v v^ Y RNCdC, d ✓ca N� ✓ G7 � .J A Y U�o•�N }"� t� d O N 56 © wC7 O co 0 00, 0 ""1 y N dGNd �,u� RECEIVED 1.3 2001 ' r c CLERK BOARD OF SUPERVISORS CONTRA-COSTA-00. P_ r�� /{/{/gyp �T � i/ •`r.- ��t�'�,4�r.__f ift•"rf.�` 'fie el— 'It 20 r I - �,� '� per,,, '�•r �5 f-; -- ��.���-'����� �,� � �� P"-��,;s„w� } fig f i r3.!%•°��. ' • A ✓ `r --- - "' - ��/'' •�—����..� d�� � � /rte , ��,, �s e _;Cor4t '/§I - "'J'' I• m:•:ti•�f.•qu.�'yr.\F.M.nw fl i--r:� )'� ,I.4)q:,,J 'l' ' CONTRA COSTA COUNTY 7 -DETENTION.FACILITY REQUEST.FOR INFORMATION ( ) MEDI REQUEST Tol Bkg# Dater:.` / ��./'<''°':./ d.1 Housing Assignment: C.Iieck 0'ne: .: '(` )jRequest,...` ( ) Grievance ( ) Appeal ( ),Other 'Request: A-7' '`A"y 4%d:iw'•Gx6.� ���/lf A l�, .d4,. 'e �7 a/.�' � 1.1 �./il'�f 'r ' ' - ��1JYs'.+`.•:Ax''f'�:` •,d1.1/.of.:'.1 F'�F',iLA'd''' 'd�.>�""�'� .'--- ,. ,F tyy .. �j�.e�• � � .1,x:7: e Z lot Pf ;:r�'F:✓�"':'• Aw ..i4'r°i:.rri fir•+" �'"�...dJ:,.+`f,:+Yr:,+•�1.:.....,.,.,u;r+?'�� �1 0: .....,� .:e Date:Rec'cJ: CU' .l' �� l/7 1 Rec'd B,*,' / �TG�ai SOY/ ��✓�o._ Rou#ed�To: *`ANSWER (..:).APPROVED.. �_(/) DENIED-(state reason) ' "r�,,u . . tom':' IMONtt". i V,,_S 21� ,6=j Date:_ / . 15 Pink:�K:` by Inmate Yellow:Reply to Inmate White:To Booking DET 024:FRM 1/2%91 ..:L.':, •::�(....l�,Y.4h :. i.l,: .a.:�.•, �, Y._T.....:' Z j1• �`i.,��F•A.il:ti fr U.•(.r'� 'iL;i"� +r ter, ' `CON:TIZA' COSTA-COUNTY. DETENTION FACILITY �.: . _ . :.: R r)'.INMAT:E.:REGlUEST FOR.INFORMATION. „ ( ') MEDICAL REQUEST-! k ,/ ,Froin: .�> °%� 7s� S "�d�� . �.+ ;�.-i=s�,u. B.kg# (DOB' 40t Housing Assignment: dl.i 7 :Checkbne (:.,.)::Request (X) Grievance " (. ),Appeal. ( )'.Other ' ,'``•6/" r/�i�'.�j'il�`, .•i� • l! .i ifi:J (l�'i"�.�a�r^d�r� '1�,/-:' .�'L•��f:��+ �::_e .G/'"'. tv zz ' �G��*"'`-��-'�C � �-- ': .f`�"C_� �!-rr��� ,,r�4''���Mfr'` '�,t'�';�•':t',"�-���d`�. _. ,,�.yr'', .. 'fit;% ;`:;•' a .�,;; , �� 1�r,�f'^��r. .�.., �,':: :t:r` t � .C::.*'.d'ti.''..ilY �.• :t�CJ4w: �.;j:j' i�.,P:.+ r'�dW� .r:;ii,f' .f//'••9,i..:f.'•� ,�"*•t•`o'!'.f::.�'�. jO 40 �.,%•'.G� A�.'.. N!].f�,��✓.:� r' �ff'..a %I. /.� F �A l�il lll�lr'"1..' t • :Date Rec'd::6:'; e /0% 'Reed APPROVED,!.'.. ( ) DENIED-(state reason) ;;:••ANSWER: � , i:. •. IV6G C.. Date:. 2•'BY; : ; `y,Pink'{Cept by Inmate'``'':,.. Yellovul Reply:to Inmate !A/Vhite:To Booking' 024:FRM'-1%2% DET 91. S �::. 4. .. .��..M" ":�� '.r++"•.t4FN,W'';;S'" fi' io`art `.+5� v::;;,r.�.t:+t,.+ � x1'S,..:d?fr{� k,?.i'',l?Jh4."y�'�L'.�•r.�.�Y�.S;.i...+d?.tip:^': ;•t"r>,• ' '• .�.::,,:m:t+,,;,:ai+� ?:lf• ��`. ,. ... `'jt;,�. PPS :�n. `CONTRA COSTA COUNTY DETENTION FACILITYr ' INMATE REQUEST-FOR INFORMATION :;(X) , . :�.: ,.. ( ) MEDICAL REQUEST!:,...�: From: -'emi+i- Bka# (DOB) ��Date G l ./_tel Q�.. Housing Assigriment:� D F A ' Check:One: ( ,) Request (,').Grievance. ( ) Appeal ( ) Other .. "x: ,. Request: V. Al .i'. %=it f i�l: -;✓i" a off:. ,.`�J'f�tr�"Gi�%. r �.d C f''R`i �f11/�f.`�'.�y' �I. .� f..�,. .r:� ir'1.�•K 'l1.iA'•'f ..'A h�� ��� �Y"l. '� 'i Date Re + 0 •Routed To: ANSWER: ( , )APPRO0 (, ) DENIED-(state reason) By: Pink:Kept by,Inmale•'::. Yellow:..Reply.so Inmate ;-White;To DET 024:FRIM 1/2/91' ,. ''F 1,•' ';iv , .���Il�'i i f.+ •.• ..��{.:+'.... 1rt.;.:.. , ......Y u... .. �:4'�:-. :F.'1�...i.�_..�...,.. +i .r:. .,.i.�. ..- �Xi+f idr�::.Ci.;'.r+�;..i-F . - ^•-5�w..s%.•.,n-fa.ti�,bH-.' d. �v'-_froom-r-:.c,.-.r....�,,,-,.:. _ -.r.:._ _^.c. - •._ _..�... .. ,.• a.' 41, �pr140 t. }• f. CONTRA COSTA COUNTY DETENTION FACILITY €. (�1() INMATE REQUEST FOR INFORMATION{. p ( ' ) MEDICAL REQUEST Frorri: it t..f'B+4 rFc=.Y.y �1,1�.Vii.=i t, .�;: _ :.�1.Bkg# .�:. � :•i�',:w•. r%��;<f _. . f (DOB). e, Housing'Assignment: t 7'rr•: Check Ones, ( ).Request . ( )"Grievance (': ) Appeal (' ) Other's, ; Request: _` kts %C, ' �' a •r ; S. AJ /"".f O Y� /,'lJ�: ✓J''�'I.f-::%r:"Y v'j i^I`' �� ,i� 44 �s".Lf.:��slr'9 ,c7'• '�' � `i��f.�:;,..,it ''..1L•�' !✓l.f�;s!d '. ,`r'. �•,�•.ar f�7J..rf•+�' �►'•:'r'��w%Ir� pft- �.-.f:. ,l'✓" 1 ..�""�� /'r:i�t:•"��' � ��++' •/'fI L^'G��.�c�l�; 'v+'�1:+r,#' i':�r+^:•4; •�f-�+i f� ..G+:,. 40.., / �P`};!•r"� ,.t',�Y'�.�r;ate✓���. .�:•L,:+'v.r 1 `";�.f^jr:r;r'(,r• �� �~ ..'�,::+ r'.: ..,r?:i 'J•? r.,t._... l•.. e��'" 'l:�.� �'.•'? �P',+?u',.f: .t<•`%``f-. .w r:.i �'lr.. ..-�ry{/f}'�Y.. {.�'s"f f�7•��'t�:;vf? 6H.,,. .t:� �' T r1'1`af�'�, .. .'��...4.''•,lr� � r!'•,�.� , + f �..1��.". ./.f��fir'L'w^"' �••r....t�:. "'^r� �'4... -1 M'lr 1 �e.` '�� ;,.^%;A '�r ?q";-� .� ;Sat,9' ,5:�ta?:•r. :r•°Y.e 3 /.'�'etoi R• - ..l /':G•.�,Y`'r••••. r'4..:- .. Routed:To:. . ANSWER: ( ) APPROVED'. ( ) DENIED-(state reason) ' By: Date: Pink:Kept by lnrriate•::.:. Yellow:Reply to Inmate White:To Booking DET,024.FRM 1/2%91 :.k..• til'. t i .-.. .rt. _ ��w;•F-�_ -�.r... ..s._— � -. .... , ,. lx ,..t:.....- -. .. '.frs .".Vs�:- � m._. r,.. CONTRA COSTA COUNTY DETENTION FACILITY INMATE REQUEST FOR INFORMATION ( ) MEDICAL REQUEST To: ! ��: . . J. From: 3ekc.,, Bkg# r jr.L.- r `/ (DOB) ' '-- Date: S Housing Assignment: r° A Check One: ( ) Request *Grievance ( ) Appeal ( ) Other. Request: S. ll. :1'15-!i�' 7�:' ii �'i � r`` r_ .wl";;'. 1.1 � r.aM 1 F�,f is ,1%, i1•.:. .P t. ' tit✓ `.. •,f' ....:Y' t r'f'A_ -:r ..e_J 5:: r.:..%�",-s+•A' 0; Date Recd: vf� �� l .Jl Rec'd Bv: y Routed To: ANSWER: ( ) APPROVED ( ) DENIED-(state reason) By: Date: Pink:Kept by Inmate Yellow:Reply to Inmate White:To Booking DET 024:FRM 1/2/91 CONTRA COSTA COUNTY f' DETENTIONFACILITY .()f) INMATE REQUEST FOR INFORMATION ( ) MEDICAL REQUEST To: J From:r I �:' ;�; Bkg# .2-C,oC� .� (DOB) = - Date: / ci i Housing Assignment: t'�• �!)k� �.y _""�' Check One: ( ) Request X) Grievance ( , ) Appeal ( ) Other Request: 01i.l S- Id" 1!.' u..Jhr lh�e'1 1 A.1i4-'� fP2,V4 i r_&' 110 140f lA,�, 1 z:.j,_. 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Yellow:Reply to Inmate r, 'White:To Booking DET 024: FRM 1/2/91 ' .:•': ' �, �.. . . r.''' ,t CONTRA COSTA COUNTY ,f DETENTION FACILITY (.\) INMATE REQUEST FOR INFORMATION ( ) MEDICAL REQUEST To: 4lr?�'-:_ 3Lr; From: rf1 ' f $'s: t � € p C C*;.,...f a. ; 4. .� Bkg#AM Y (DOB) Date: : 5 / "17 / Housing Assignment: l4 i.'f-:: (jr, Check One: ( ) Request ( ) Grievance ( ) Appeal ( ) Other Request: .i' .ky..��t t rz_ (...o!./' Date Rec'd: / / Rec'd Bye Routed To: ANSWER: ( ) APPROVED ( ) DENIED-(state reason) By:- Date: Pink:Kept by Inmate Yellow:Reply to Inmate White:To Booking DET 024: FRM 1/2/91 CONTRA COSTA COUNTY DETENTION FACILITY INMATE REQUEST FOR INFORMATION ( ) MEDICAL REQUEST 1-47 From: 1•liw, f� �.. 3 .. l B k g# f c: :ir.."G ^: > Date: C`/ � �- / r. Housing Assignment: i4 Check One: ( ) Request (X) Grievance ( ) Appeal ( ) Other Request: CI f�./_.-fu t r`S:Ir 3� /���Y�f%i.N i`,7 r!. r�••I.{,r f`!!:r'.s��J �,��-r /'"rl�.fJ.iL.r�`.�.. x.i. r 1••• `J�'i.S' .. d.F`�'".N• Fa,.+r!1;'•2i J i '1,.: -.�..i.. ,�Si` ..X • - J +•''�.� !,•`�.'�.1�F ��•y.1� l l'7.M^�" i'%• r'/':�✓r:•t.r� ,t.. s. L 41-1 t`...4•+ b,Y,.r�r'.if1 J:{. f:�'d'td t 'i;t° ._1!xes', r`r+"fs1 ? �'.[r%. _ v � . r i. +L.••..� .�i-.�`i�'c `!:•( .f _�':M' i. -r�� ' '�r � r ��• 6' I r ' �r`r'a'Fv�.� ✓r.l'M F .�. •„ta•!'T .i-'� °. .s.�....� :'�'s'rlr . t r Date Rec'd: % 7 C /0' Rec'd Bye v11A-r'-_ Routed To: ANSWER: ( ) APPROVED ( ) DENIED-(state reason) By: Date: Pink:Kept by Inmate Yellow:Reply to Inmate`. White:To Booking DET 024:FRM 1/2/91 ' .... .....r+.,.e..�ra��r+.a.�•-•�_.8?!`.'wT�atw.apv+y+-r�vw+—..wr�._ ...«..... .. ...--- _ .'yz.rx;- .. -_ i r X•f.a• C'O`NTRA COSTA COUNTY DETENTION FACILITY ( ) INMATE REQUEST FOR INFORMATION' ( ) MEDICAL REQUEST .From: f7c" 4f=- : f�,; ,� �a'r�'� .. .�''�� aj Bkg# (DOB) Date: l l r.Y tHousing ASsignment: .<A! ' Check One: ( ) Request ( ).Grievance ( ).Appeal ( ) Other Request:mh i-l. ';✓�x: '`9 'F�i ,�(u' y, /• t. . a.L'/Li•S{.,: � �4 I•,1d r "•`�',�rti;s•� _i P)4i '•V%i _ C:, i,8, !.•�:. .�._. �r'a:} y ,, ✓ ,,r+- l +/// � ,rim_ r,�� :.� ^�- I'1.+ ..��'tr^R L,l;cg I ,c1:�ti".l� �.� ,r_..�q� ::: f �'� •a.•�/�t.�. . :�'�•s:rr� j /A Ciii .s�+ . �f:1 �y:A 1-2 l AJ4 p / q ?�''..^'' !0F _ f d•1 fYi:/�1��. ��`Yi.11 6.1 d•A�.. F' �+' �^�+yt'� r< s' P. �"'!s+$I' �r'r° _l:q T �• A),- 1[,.•!l R,.r p`./TV�" iiifJ'" w .p �'`^'/ F•�i�}i t A ��:.,ta'i z^_''r't..:: __ a J�•t # � .�6�. '" :;I'i.r . ,E �r... r..... Date Rec'd: S / 7> Rec'd By: IeA-C.L., Routed To: ANSWER: ( ) APPROVED ( ) DENIED-(state reason) \ Date' / \Cet by lrimate . Yellow;Reply to Inmate pWhite:To Booking �T FRM:'1/2/914 ``-, jai: AiAl CONTRA COSTA COUNTY .:DETENTION FACILITY (k�YINMATE REQUEST FOR INFORMATION ( ) MEDICAL REQUEST + i From: in Bkg# -I, l/ (DOB) Date: Housing Assignment: <:' �_. r.. •� Check One-. ( ) Request (fir) Grievance ( ) Appeal ( ) Other Request: °r , '; :w,:, 1k. ;s` , ,* ' s` r,=-;S 1c Yom' . 1, yp, `7 .. v tYi•v t' �• ,�,•.,� a�!�_�.��y..��' ,"6, �,q, . •sf• � �'f. at' .I��• /f"t'"i'�,.,.,_. 1�� y i;Y.f1. .f."iii J. .f!'�lAl.i .:.t�,.1fe�- •�n �••r �-:v',",!e�•1 J.'•.'���C...'F�~ - .f w�� /+r.'J'f/n �„•.� ..sn,ASG/-�J J!':�::r'ti',r S.. . 'S.r 'F' ✓ r� Ji A� .. _J `rr�� ,•1. J 'hl��r l ✓�. �f' /IwT :'�' `'�/�,r 'l. _���1!.!/�r Date Rec'd: / G+ Rec'd By: Routed To: / ANSWER:. (. ) APPROVED ( ) DENIED-(state reason) By: Date: / Pink:Kept by Inmate Yellow:Reply'to Inmate .White:To Booking y DET 024:ERM 1/2/91.. ' .X:.y+„ti':• _ ::S rJ IVP`-4,`" .- CONTRA COSTA COUNTY DETENTION FACILITY ( ) INMATE REQUEST FOR INFORMATION ( ) MEDICAL REQUEST To: From: Bkg# (DOB) Date: / / Housing Assignment: Check One: ( ) Request ( ) Grievance ( ) Appeal ( ) Other Request: 'i. r.i fr_�� ,.,�l:i �f1 'i' ' {'f V i' w'`c•.�°:.� :ff �:i.... ' /6.'es+ ..moi flv 1� "r'�r '{,, -�•:'"`. r"::� 'P•^.. y', .6: �� .r.:Awr O�� �{ sata'.:'r.•� `Fa 's': .�:' �`r V� ;dfi: s'l;if�F" :•.r.`.,..i%r7,a r�`i, !•, 1P_ �. t �:: r'a.�:�.:F.' �'/i,•�/:: s+=.''�It''t I!Y'�•' ��:r,.�.:.7 �3 p,e, �v, �,'y .�.. c. ell • �;� � Date Rec'd: / / Rec'd By* / / Rec'd By* Routed To: ANSWER: ( ) APPROVED ( ) DENIED-(state reason) By: Date: Pink:Kept by Inmate Yellow:Reply to Inmate 'White:To Booking DET 024:FRM 1/2/91 91 CONTRA COSTA COUNTY DETENTION FACILITY n (rr.) INMATE REQUEST FOR INFORMATION ( ) MEDICAL REQUEST To: .: ;:i 4 ; .5 From: /1'r,;, .: :a AA 4.; .�*.... 6, "j Bkg# s: e. , (DOB) - _�.F' Date: ..S l i l Housing Assignment: ;i,,, , )• i .�, a L Check One: ()6-Request ()() Grievance ( ) Appeal ( ) Other Request: ._'t" olds, Date Rec'd: / / Rec'd By Routed To: _ ANSWER: -(state APPROVED ( ) DENIED-(state reason) By: Date: Pink:Kept by Inmate Yellow:Reply to Inmate White:To Booking DET 024: FRM 1/2/91 . k. + elk tit O v ' � k 1 ' ✓ v � I r � 'r $ � 4 f CLAni BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNLA BOARD ACT10July 24, 2001 Claim Against the County, or District Governed by ) the Board of Supervisors, Routing Endorsements, I NOTICE TO CLAIMANT and Board Action. All Section references are to ► The copy of this document mailed to you is your California Government Codes. I notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given pursuant to Government Code Section 913 and JUN 6 915.4. Please note all "Warnings". AMOUNT: no 2 20af COUNTY CouNSE4 MARTINEZ CAUF. CLAIMANT: Sim Jackson ATTORNTEY: None DATE RECEIVED: June 25, 2001 ADDRESS: 901 Court St. BY DELIVERY TO CLERK ON: June 25, 2001 Martinez, Ca 94553 BY MAIL POSTMARKED: June 4, 2001 I. FR0.1VI: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JO E Clr ., Dated: June 25, 2001 By: Deputy (� i H. FROM County Counsel TO: Clerk of the Board of Supervisors ( This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). I ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: G—oZ1-0 I By: - _Deputy County Counsel III. FROIN1: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present: (�) This Claim is rejected in full. ( ) Other: I certif that this is a true and correct copy of the Board's Order entered in its minutes for this date. _a&/b4 Dated: ( JOHN SWEETEN Clerk, By &, Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF MAMP G I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: d.�( .�� By: JOHN SWELTEN, CLERK By �'Z/`�eputy Clerk RECEIVED G��evatice- Cari_� / z -- .1-- JUN 2 5 200 CLERK BOARD OF SUPERVISORS r# CONTRA COSTA CO. /ec e[.�Cc�e�� —�— �R.�rTprToiS �/a t ! CLS . it,voin _7G -a,- s ----- ��CCG2ToC-o .5 7Any' . 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P- P � S�_T—/g c�rT.�. t_��.�8�0�._yb�w pr v Q.r�—l�Lv-.S—S tea.✓c�,e_�.._e20 C— p SeC tT`L�t-1F�r— fsCC _(.�Oc�r ki.h_b_iC.r—c- A et—?- Ic low��c�/�T� , !_/_2r���''�.._r _�..e_��s�i_���r_c��..r_T�► ���'��- eo Oe.,- r �F'�1_r��d�c�.cr. �,_ha.S C c> vn /e T�� _/_ _h o✓_e a�G��'�-�u�.Ss�� T InrrJG.T�/ Ta.GleSea�o_��.Sm�.o--Q— .!v_��Yj'Yc -�i.,,�--t—��-T�?� �a-f7-%7� C`Gc._/_h o r�%�To �.e e�o✓ T��.—�LLr_r_!. ,G.S�I.n.S_c.�©_t.�:,-rl'1-5,--(J�r Kh'EC��Tc��/cam c;�o�<<•�T6/his_�ey' - a 8 T� r»t Q�e,..r_�!_�s�/'on—��C�✓✓ /rte N���o�S��!_c r► �v_r.�.'t,�4.�csSeS_ ,Go— r✓✓ / g:��r�c..���.. �.� a:.�. knit- e- e-✓ �� Q�S ►^� �., Cam' • v t h Tn f' io- —�i_ �-� b.-�G.f ��_GL_C�C4�/'r-��/_G_l��C.l°.t- �/_I_�—�h_/a!1-Ga./'e S �'I o_r�g��..��. .rL (JC..►� � f.., At 54 �a G�.��-(lt-h-�r-�.c.•��-�t��—•�-�Q��E���r_a��,.cL�f C e tf2���Lr.7�fS�_LS o �g_ _/,..3�/_/CSS/nC�._f_7'!i S CCS✓✓/C+���. D�l� .�ts`��t;.._'�� � et 6 u, t 1� §� 0 i �1 O;r► � P qa `L. .4N v •• a ._ :. cn RECEIVED- - -JUL 3 0 200 _ _.. arThe7-�_Lw,9yS --. .- _--•- - - CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. 1 _ - 72 ., G/e r a .?fie._-ward o ✓�,SoFS. _ _ i J �e GL..4o;&_..L1G�i•�?c�.r,T Vie.. l,�eS%:.fl_- Ca y a��e /IGcQ. Jd�n �w.�cr Gler,� ae 6vlir� ate. ' 13:5 14- e rL.)l 6 c -S /4.S 1'4 e4ol�.:/,1-7 _7 re ct cc57 Te '6 e. a.r D.r.. .Si:c.G�. erS,a/1 1-YAb"? nj&Y. �-l.ve,. . �/r./ - ;6.7 _,t /S. . ./'�'�S�h�.. `�G I-': rd UL 4-6 _ t. e-,:�,r7 rc"e,//� Z In Al :� I _ 01 Cc) o NN � a o 'er � .• L� )Nvo Op to ��1 •��i 4 4i; ad t� T �, a �e1�lv • APPLICATION TO FILE LATE CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA BOARD ACTION July 24, 2001 Application to File Late Claim ) NOTICE TO APPLICANT Against the County, Routing ) The copy of this document mailed to you is your Endorsements, and Board Action.) notice of the action taken on your application by (All Section References are to ) the Board of Supervisors (Paragraph III, below), California Government Code.) given pursuant to Government Code Sections 911.8 and 915.4. Please note the "WARNING" below. Donald R. Douglas �p— isIV;r,III Claimant: g Attorney: None JUN 2 9 2001 Address: 901 Court St COUNTY COUNSEL Martinez, CA 94553 MARTINEZ,CALIF. Amount: Unknown By delivery to Clerk on: June 22, 2001 Date Received: By mail,postmarked on: June 21, 2001 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above noted Application to File Late aim. June 28, 2001 JOHN SWEETEN, Clerk, By:, &--6E--P- DATED: UTY 11. FROM: County Counsel TO: Jerk of t e Board of Supervisors ( ) The Board should grant this Application to File Late Claim (Section 911.6). (t The Board should deny this Application to File Late Claim (Section 911.6). DATED: SILVANO B. MARCHESI, County Counsel, By`_ � EPUTY III. BOARD ORDER By unanimous vote of Supervisors present (Check one only) ( ) This Application is granted (Section 911.6). This Application to File Late Claim is denied (Section 911.6). I certify that this a true and correct copy of the Board's Order entered in its min tes for this date. _DATE JOHN SWEETEN,Clerk,By: / DEPUTY WARNING (Gov. Code §911.8) If you wish to file a court action on this matter,you must first petition the appropriate court for an order relieving you from the provisions of Government Code Section 945.4 (claims presentation requirement). See Government Code Section 946.6. Such petition must be filed with the court within six (6) months from the date your application for leave to present a late claim was denied. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney,you should do so immediately. 1V. FROM: Clerk of the Board TO: (1) County Counsel (2) County Administrator Attached are copies of the above Application. We notified the applicant of the Board's action on this Application by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. DATED: JOHN SWEETEN, Clerk, By: DEPUTY V. FROM: (1) County Counsel (2) County Administrator TO: Clerk of the Board of Supervisors Received copies of this Application and Board Order. DATED: County Counsel, By: County Administrator,By: AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States,over age 18; and that today I deposited in the United States Postal Service in Martinez, California,postage fully prepaid a certified copy of the Board Order and Notice of Claimant, addressed to the claimant as shown above. �i, , Dated: 1, By: John Sweeten,Clerk By ' i DEPUTY a F RECEIVED 7 I� JUN 2 2 2001 CLERK BOARD OF SUPERVISORS NTRACOSTACO-- - 14C ID9....... AYL IF I t 4 . lam l� r� a � lot e -- —17 q r� .� /i S Clai:.i to: BOARD.OF SUPERVISORS OF CONTRA COSTA COUNTY -� INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100 ' day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Gov't Code 911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. ****************************************************************************************** RE: Claim By Reserved for Clerk's filing stamp D 6 , .�1�� 1 u C1 G s RECEIVED Against the County of Contra Costa or ) JUN 072001 C J� r G CO 5 I a COy�l f �/ District) CLERK ONTRAOF SUPERVISORS COSTA CO. (Fill in name) 4t S k e,r ) T J���lI f'Yt�a The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named district in the sum of$300, QQ and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) 'INor Fa'1 cec tor,) V4 e- �0 -T 0y L)h K Pub I -I c T1,%qy j-00 k r►�a� S 13 0 HP44-1 K v u I r0✓"I 15� 7� ,hdlg,r,:2 1A �I-V r_ �� �h� ye ��t2 b1J' S 9t, Rya h 2. Where did the damage or injury occur? (Include city and county) i�o tb/f 1/elm` 11vi'Vor1f QC_hecC C et C0%J&YG C65�a r eta 3. How did damage or injury occur? (Give full details; use extra paper if required) S k'�ip ? {(� QVV 1It � 'I� VIA % a r Z k av e 0 to r�e r&rd r *a k i 149 OL, b a k r 0� 0h� r a fvvq ( 1 cow,; t- � � 1 +1 _ 10 Call .�1. What particular act or omission on the art of county or district officers, servants, or employees caused the injury or damage? .eC6 ►=015 ;5 N/ r e C e;V �1��_�i- f'.- ems. InC� Fs✓�eve0; p�/1. A, 6=1• 1 � '"�S �'' o Y � G C) �9� `��� '(� �, 'C"of ► ( f'dto -�In _ 5. What are the names of county ordistrict officers, servants, or employees causing the damage or injury? S � a ti a gad Nor f�� W V g A-�' � i%' Co -,f►-�, CosfA Co o P,*,v S �v � f� 0ei0-k Bld,5. Iocacf ov� ftA.u-,r (Zd. YVIar-r; �eZ , Ca 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. 5�A-, P yG N c1 H G( �( � Vl v r,3W a 5S r 54 1/g'8 - :QV�1� C�K9 e Y t c�� - _ o --� W e• -To �-�,;S cAa� V1Q boy ea 14 r; KJ d►�o� r�-t'� r h �� Ke., A gU t ti � USf- SGS-`/�� ti / Sa.�d'- reCn vds, T Eow-was the,amburt claimed above computed? (Include the estimated amount of any prospective injury or damage.) b ��C h �V�• a fat.e t 8. Names and addresses of witnesses, doctors, and hospitals. JU 5 6e VT 0 � o 9. 'last the expenditures tures ou made on�ctoun ofhis acctden or to u �p ��!�� � cO, �= P Y J rY. `'���S Wp S DATE TEME AMOUNT a � "gyp WJE �000 tol)Z 4001 �o v e- 014 � ,,%l cep! V� 'lace ) Gov. Code Sec. 910.2 provides "The claim must be ) signed by the claimant or by some person on his behalf." SEND NOTICES TO: (Attorney Name and Address of Attorney ) } (Claimant's Signatu (Address) OC Telephone No. )Telephone No.( NOTICE Section 72 of the Penal Code provides: Every person who,with intent to defraud,presents for allowance or the payment to any state board or officer,or to any county,city,or district board or officer,authorized to allow or pay the same if genuine,any false or fraudulent claim,bill,account, voucher,or writing,is punishable either by imprisonment in the county jail for a period of not more than one year,by a fine of not exceeding one thousand(S 1,000),or by both such imprisonment and fine,or by imprisonment in the state prison,by a fine of not exceeding ten thousand dollars(S 10,000),or by both such imprisonment and fine. Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100`h day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Gov't Code 911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. ****************************************************************************************** RE: Claim By Reserved for Clerk's filing stamp �Usk Against the County of Contra Costa or ) District) (Fill in name) ) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named district in the sum of$ C? , On and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour)PI.&I F Mot -t-0 Wit 01, , 'ci V' -oku'w, 4 Wt. F;`cd' � Q. C b TA e 11A 2. Where did the damage or injury occur? (Include city and county) 3. How did the damage or injury occur? (Give full details; use extra paper if required) 4. What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? 5. What are the names of county or district officers, servants, or employees causing the damage or injury? 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage.) 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) 8. Names and addresses of witnesses, doctors, and hospitals. 9. List the expenditures you made on account of this accident or injury. DATE TIlV E AMOUNT Gov. Code Sec. 910.2 provides "The claim must be signed by the claimant or by some person on his behalf." SEND NOTICES TO: (Attorney Name and Address of Attorney ) (Claimant's Si'nature) p (Address) Telephone No. - ) Telephone No. NOTICE Section 72 of the Penal Code provides: Every person who,with intent to defraud,presents for allowance or the payment to any state board or officer,or to any county,city,or district board or officer,authorized to allow or pay the same if genuine,any false or fraudulent claim,bill,account, voucher,or writing,.is punishable either by imprisonment in the county jail for a period of not more than one year,by a fine of not exceeding one thousand(S 1,000), or by both such imprisonment and fine,or by imprisonment in the state prison,by a fine of not exceeding ten thousand dollars(S 10,000),or by both such imprisonment and fine. Claims against a California governmental entity or employee. 6 SW LR 550 §901. Date of accrual of cause of action in determining time for presenting claim [History and References] [Notes of Decisions] For the purpose of computing the time limits prescribed by Sections 911.2, 911.4, 912, and 945.6, the date of the accrual of a cause of action to which a claim relates is the date upon which the cause of action would be deemed to have accrued within the meaning of the statute of limitations which would be applicable thereto if there were no requirement that a claim be presented to and be acted upon by the public entity before an action could be commenced thereon. However, the date upon which a cause of action for equitable indemnity or partial equitable indemnity accrues shall be the date upon which a defendant is served with the complaint giving rise to the defendant's claim for equitable indemnity or partial equitable indemnity against the public entity. Deering's California Codes Annotated 1 Copyright 2001 Matthew Bender&Company, Inc.,a member of the Lexis-Nexis®Group. All rights reserved. v City and County of San Francisco (1998, 1 st Dist)64 Cal App 4th 635, 75 Cal Rptr 2d 341 §911.2. Times for presentment of claims [History and References] [Notes of Decisions] A claim relating to a cause of action for death or for injury to person or to personal property or growing crops shall be presented as provided in Article 2 (commencing with Section 915) of this chapter not later than six months after the accrual of the cause of action. A claim relating to any other cause of action shall be presented as provided in Article 2 (commencing with Section 915)of this chapter not later than one year after the accrual of the cause of action. Deering's California Codes Annotated 1 Copyright 2001 Matthew Bender&Company, Inc.,a member of the Lexis-Nexis®Group. All rights reserved. . .ti„c.•-;,r�-.,.%�.vµ�`a''0Cc{"'.;�}:'li,'yd,`S�!•:s�;�y%• .�G^".i"."tiJ'.. �J:::4M+r`�Y;.;;....•:'�,r'� .. ��..:.�:�.`:�'�.� . . , CONTRA COSTA--"COUNTY DETENTION FACILITY ` {Y) INMATE REQUEST FOR INFORMATION ( ) MEDICAL REQUEST To: CA 1A t7r0k 1< From: I 1 A t1 cz CA Bkg# ogn,I" Date?€: / / to / Housing Assignment: Check One: Request - ( ) q ( ) Grievance ( Appeal----( ) Other Request:. %� c9 U �. a r l •" �e ... �� ? ®' VAA cit �+ rj 0 i wt o Vea,pa vae t4. Rill C - _ 1 S I;; Date Rec'd:11194�/ 151 Recd BX. P•.V Routed To: ANSWER: ( ).APPROVED ( ) DENIED-(state reason) ; i By: Date: Pink:Kept by,Inmate Yellow:Reply to Inmate White:To Booking DET 024: FIR 1/2/'91 v "rld 4 fA ��:yj q� •'��13lICvh4�o.� � �•c�Lt �.�tt4ra. ...�:•.�•' At `•'N ,\,r+. ,h`�r'* 'sem, � 0 ID RM".Nry (yT p7/.^may, ' �'�''•r�y +� x9 A ON tw t hr.� r G CLABI. BOARD OF 5UPERNTISORS OF CONTRA COSTA COUNTYCALIFORMA BOARS? ACT1011t July. 24, 2001 Claim Against the County, or District Governed by I the Board of Supervisors, Routing Endorsements, I NOTICE TO CLAIMANT and Board Action. All Section references are to I The copy of this document mailed to you is your California Government Codes, notice of the action taken on your claim by the my.=Mvim Board of Supervisors. (Paragraph IV below), given pursuant to Government Code Section 913 and J U L o 2 2009 915.4. Please note all "Warnings". AMOUNT: Unknown COUNTY COUNSEL MARTINEz CALIF. CLAIMANT: E, Galindo, Q. Galindo, M. Galindo, ..& M Arienza ATTORNEY: Romeo Sa jor DATE RECEIVED: June 29, 2001 ADDRESS: 156 S. Spruce Ave #202 BY DELIVERY TO CLERK ON: June 29, 2001 S. San Francisco, CA 94080 BY MAIL POSTMARKED: June 27, 2001 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN TEN, Cler Dated: June 29, 2001 By: Deputy �j` H. FROIVL County Counsel TO: Clerk of the Board of Supervisors ( Tis claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). I ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: By: 6 Deputy County Counsel III, FROIvL• Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present: ( This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: . JOHN SWEETEli Clerk, By / uT/ Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personallti served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFMAN71T OF MAUX G I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copyofof this Board Order and Notice to Claimant, addressed to the clai ant as shown above. Dated: �,�'I �� C7� By: JOHN SWEETEN; CLERK By l/� � eputy Clerk Lain Offices of R09YEO C. SAJOR 156 South Spruce Avenue,Ste.202 South San Francisco, 94080 SHARON HYMES-OFFORD Tel.#(650)869-4239 Fax#(6(650)869-4380 JUN 2 8 2001 June 26, 2001 RECEIVED PENNY BAILEY Contra Costa Sherriff's Office JUN 2 9 2001 Risk Management Division 2530 Arnold Drive, Suite 140 CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. Martinez, CA 94553 Re: Our Clients Egbert Galindo, Candonino Galindo, Marilyn Galindo and Maybelline Arienza Your Insured Contra Costa Sheriff's Office, City of San Pablo and Mark Robert Kohlmar Date of Loss 5/01/01 Claim # 47683 Dear Ms. Bailey: Enclosed please find the Formal Government Claim we are presenting for the above- named claimants for the accident of 5/01/01 against Mark Robert Kohlmar, Contra Costa Sheriff's office and the City of San Pablo. Please reply in writing if this is the correct agency that accepts the Government Claims for the Contra Costa Sheriff's office and the City of San Pablo. If you have any questions or wish to discuss the above claim, please feel free to give us a call. Very truly yours, /s/ ROMEO C. SAJOR Attorney at Law Law Offices of R09YEO C. S3,70R 156 So.Spruce Ave.,Ste 202, So.San Francisco,Ca 94080 7e[(650)869-4239- 'FaX(650)4380 SENT CERTIFIED MAIL 7000 1670 0007 1479 9992 June 26, 2001 CONTRA COSTA COUNTY SHERIFF'S OFFICE RISK MANAGEMENT DIVISION 2530 ARNOLD DRIVE, SUITE 140 MARTINEZ, CA 94553 ATTENTION: PENNY BAILEY Re: Our Client : Egbert Galindo, Candonino Galindo, Marilyn Galindo, and Maybelline Arienza Date of Accident : 05/01/01 Type of Incident : Auto vs. Auto Accident Dear Ms. Bailey: You are hereby notified that claimants, EGBERT GALINDO, CANDONINO GALINDO, MARILYN GALINDO, and MAYBELLINE ARIENZA, hereby presents a formal claim for damages against the Mark Robert Kohlmar, County of Contra Costa and the City of San Pablo, in reference to the above stated accident. 1 . Claimants Name and Address: .1 . EGBERT GALINDO - 59 Crocker Ave. , Daly City, CA 94014 2. CANDIDO GALINDO - 59 Crocker Ave. , Daly City, CA 94014 3. MARILYN GALINDO - 59 Crocker Ave. , Daly City, CA 94014 4. MAYBELLINE ARIENZA - 59 Crocker Ave. , Daly City, CA 94014 5. The Post Office Address to which claimant desires notices to be sent: The Law Offices of ROMEO C. SAJOR, 156 South Spruce Ave. , Suite 202, South San Francisco, CA 94080. June 26, 2001 City of San Pablo Page Two 6. The Date, Place and other circumstances of the occurrence iq ving rise to the claim: This claim is based on personal injuries sustained by claimants on May 01 , 2001, at Rumrill Blvd. and Broadway Ave. , in the City of San Pablo, County of Contra Costa, under the following circumstances: Claimants were eastbound on Broadway Ave. going through the intersection at Rumrill Blvd. on a green light . Suddenly, without prior and sufficient warning, a police officer on duty driving a sheriff's vehicle entered through the intersection on a red light from northbound Rumrill Blvd. , thus causing both cars to collide. 6. General description of the injury incurred so far as it is known at the time the claim is presented: Due to the collision, all three claimants suffered injuries but not necessarily limited to the following: 1) Egbert Galindo - Pain to the head, neck, shoulder and legs. 2) Candonino Galindo - Pain to the head, neck, and legs 3) Marilyn Galindo - Pain to the right shoulder, head and neck. 4) Maybelline Arienza - Pain to the head and neck. 7. The names of the public employee (s) allegedly causing the injury, if known : Officer Mark Robert Kohlmar - of the Contra Costa Sheriff Department caused the accident for driving at a speed, from which he could not stop prior to entering an intersection in violation of a red signal (22350 V. C. and 27453 (a) V. C. ) 8. The amount of damage claimed: All three claimants are still treating and are incurring medical bills, but are not necessarily limited to the following: Dr. Joseph F. Scannell - all four claimants are still undergoing chiropractic treatments and have not been discharged to this current date. Currently we are attempting to gather all the additional medical records and billing information we will need to present our formal demand package. Please review the above information June 26, 2001 City of San Pablo Page Three and advise us if there are additional documentation you will need to evaluate our client's claim. Thank you for your attention on the above matter. Very truly yours, OME0 C. , R Attorney at Law cK CL ar �...� Ir >r _ � � T v a �i 0 '0 v C3 (1) c) c' � N a � m WU) Earn [r' � m (D � d O Cc p d ( } ,� 1 co ` N t to Q c E� z C 0 W o .� u) tB CY) ol -- � CJ � ri0 C4 � c 00 G �O d Qj U 3 V y� p 0 Q U � V v y `V. ' AMENDED �, 4 BOARD OF SUPERVISORS OF CONTRA COSTA COU TTY, CALIFORNIA BOARD ACTIO tIt July 24, 2001 Claim Against the County, or District Governed b�,y ► 1 the Board of Supervisors, Routing Endorsements, ) . NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document mailed to you is your California Government Codes. 1 notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". AMOUNT: $10,000 J U L i 1 2009 CLAIMANT: Donnell YoungMARTINEZCALIFCOUNsEL ATf'ORNrEY: None DATE RECEIVED: July 6, 2001 ADDRESS: 901 lourt 94553 BY DELIVERY TO CLERK ON: Jul 6, 2001 Martinez, BY MAIL POSTMARKED: July 4, 2001 L FRON"L• Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOg I E EN CI rk Dated: July 9, 2001 By: Deputy H. FROM.—County Counsel TO: Clerk of the Board of Supervisors (tll This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). l ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and. send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: 7—fl 0 By: mL& Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). X. BOARD ORDER: By unanimous vote of the Supervisors present: f This Claim is rejected in full. ( Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: �( JOHN SWEETEN Clerk, By. r' puty Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF MAIIdNG I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certifiedcopyof this Board Order and Notice to Claimant, addressed to the claimant as shown above. 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L .- - v..- , . .'.. .. .. , . ... .� - , I .,�, k�� P . • 1 OFFICE OF THE SHERIFF V0, XR�jpP Warren E. Rupf Contra Costa County F Cp SHERIFF Martinez Detention Facilitv �Y 1000 Ward Street Kathryn J. Holmes .�a+.a� Martinez, California 94553 o __•.,� Undersheriff (925)646-2199 �9 CoSTQ►�O To: Inmate Donnell Young, Booking#2001005363 From: Lieutenant John Celestre acility Commander Date: June 26, 2001 Subject: Grievances Date June 17, 18, and 21, 2001 I have reviewed your grievance documents dated June 17, 18,and 21, 2001. I am denying your grievances on the basis that you have not offered any evidence or information that would tend to support or prove your accusations. Your advisor, Inmate Mosbarger, has used his usual tactic of citing multiple cases and/or legal guidelines without offering any supporting information. In reference to what appears to be your basic grievance issues-. Did you actually request staff assistance in regards to your disciplinary hearing on 5-20-01? According to the Hearing Sheet it was you who waived the 24 hour rule, and requested an immediate hearing. Your statement that the finding of"guilty based on report" is insufficient to satisfy evidence standards is incorrect both on it's face and it's intent. The report documented the deputy's account of what had occurred,and in effect was used in place of the deputy's testimony. Saying that the report does not satisfy evidence standards is not applicable since the disciplinary hearing is not held to the same legal standards as a court proceeding, and the admissibility of statements is not held to the same standard as outlined in the California Evidence Code. Exactly how or why do we have, " unlawful witness policy (75 F 3d 517)? As to your issues concerning ADA; has your alleged ADA condition been verified? Have you been found to be incompetent to stand trial on your criminal charges? If you are capable of understanding your criminal charges and assisting in your defense; then you should be capable of understanding the disciplinary procedures in this facility. In conclusion, the appeal and/or grievance policy within this facility is not meaningless, but you must offer some supporting information that would justify a reversal of the disciplinary hearing. cc-. Commander Gregg Moore Captain Rich Woolard Inmate's Booking AN EQUAL OPPORTUNITY EMPLOYER z CONTRA COSTA COUNTY DETENTION FACILITY INMATE REQUEST FOR INFORMATION ( ) MEDICAL REQUEST jTo: ,�,'� From: %4 nALL yQ ,s Bkg# Jao�Q�53 (q� 3 (DOB) j Date: C> (/ o ( Housing Assignment: .42 - A -6 Check One: ( ) Request (,*I'Grievance ( prAppeal ( ) Other Request: r9AAca e Z C2'.J9,k&7,. 1 A 0 13 &C T lJCQ.J a.n cl he)3rLJ"e f,C,_x Co Le .qars! ��r����Q Ir1SUrr�Ql1T SQ�yjl' of1/ic6nc.,-Q S S , er.d Ckgh'anS SQ-aks ✓olurvNm , (Cw cma"j Date Rec'd: Rec'd By: / I Routed To: ANSWER: ( ) APPROVED ( ) DENIED-(state reason) i By: Date: Pink:Kept by Inmate Yellow:Reply to Inmate White:To Booking DET 024:FRM 1/2.191 V � WAR • • ,• • Blow G AJ, • FarlMr. 1 • 1 �__.X 64 wk,�R INA X-77WANW, M ray .j I� ME i ra Y � �Y � � • :y TL r t . ....... ....:::. ,: . . ._. .•.tea-- - �.t,5 _ jr s — 11 Y- UAn }s . ....:..... .... La -- _. 47 . � i f i �...,. -..:.. ._,...; �� �+ napcv. lb -jazz 41et OD OD �- Q 27 r <, s� Pc 117, X73 a 04 J � 1 �r.c. �• 7..� <ji At the time of mailing there was regular de'.iver-v of united States mail betvveen the ` place of deposit and the place of address. _ I declare under penalty of perjury under the !avvs of the State of California that the —� foregoing is true and correct. Date: _ ------------------- (Signature of person mail' ng) _ (tisme of person mailing, _typed or printed) • L: h �p M M h tiv v h a J off` 4 � 2 � ^ Y� O 0 - y . b Q OD a O O M� LT ( ) Claim is not timely filed. The Clerk should return c claimant's right to apply for leave to present a late c ( ) Other: Dated: �Z(� ��tl By:� III, FRONL• Clerk of the Board TO: County Cot ( ) Claim was returned as untimely with notice to clain BOARD ORDER: By unanimous vote of the This Claim is rejected in full. ( Other: I certify that this is a true and correct copy of th, Dated. MN SWEETEN WARNING (C Subject to certain exceptions, you have only six (6) mon in the mail to file a court action on this claim. See Gov attorney of your choice in connection with this matter. immediately. *For Additional Warning See Reverse Sic AFFIDA) I declare under penalty of perjury that I am now, and at States, over age 18; and that today I deposited in the Ur prepai certified copy of this Board Order and Notice Dated: By: JOHN SWEETEN, CLE 1 i SILVANO B.MARCHESI DEPUTIES: i� AL PHILLIP S.ALTHOFF COUNTY COUNSEL i ---- \�. JANICE L.AMENTA NORAG.BARLOW SHARON L. ANDERSON %�- - ;_ + B.REBECCA BYRNES ASSISTANT COUNTY COUNSEL / / l ; -��.\ ANDREAW.CASSIDY C ,,NTRA COSTA,;C..UN1 Y MONIKA L.COOPER GREGORY C.HARVEY OFFICE•OF-THE,COUN�T: IN MAR ES..ESTIS ASSISTANT COUNTY COUNSEL I ,i-x-��" I d LILLIANT.FUJII (;COU�ITY--ADMINISTRATIONIBUILDING.-)I JANET L.HOLMES DENNIS C.GRAVES 65lpRINE-8TR. ETq 9th-.FLOOR KEVIN T.KERR BERNARD L.KNAPP SENIOR FINANCIAL COUNSEL MARTINEZ;CALIF®R 1'!194.553- 229 EDWARD V.LANE.JR. GAYLE NUGGET �7]\`� - 1� BEATRICE LIU �; �LY/ MARY ANN MASON OFFICEMANAGER \��Is, - PAUL R.MUNIZ Ci U VALERIE)RANCHE PHONE (925) 335-1800 NOTICE OF INSUFFIENCY DAVID NS IDT CIHM FAX (925) 646-1078 DANAJ.SILV RIDT AND/OR JACQUELINE Y.WOODS NON-ACCEPTANCE OF CLAIM PAMELA J.ZAID TO: Doimell Young Martinez Detention Facility D-A-6 #2001005363 901 Court Street Martinez, CA 94553 RE: CLAIM OF: Donnell Young Please Take Notice as Follows: The claim you presented against the County of Contra Costa or District governed by the Board of Supervisors fails to comply substantially with the requirements of Califoniia Government Code Section 910 and 910.2, or is otherwise insufficient for the reasons checked below: ") 1. The claim fails to state the name and post office address of the claimant. J 2. The claim fails to state the post office address to which the person presenting the clafin desires notices to he sent. [XX] 3. The claim fails to state the date, place or other circumstances of the occurrence or transaction which gave rise to the claim asserted. [XX] 4. The claim fails to state the name(s) of the public employee(s) causing the injury, damage, or loss, if known. [XX] 5. The claim fails to state whether thee amount claitned exceeds ten thousand dollars ($10,000). If the claim totals less than ten thousand dollars ($10,000), the claim fails to state the amount claimed as of the date of presentation, the estimated amount of wiy prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. If the amount claimed exceeds ten thousand dollars ($10,000), the claim fails to state whether jurisdiction over the claim would rest in municipal or superior court. [ 16. The claim is not signed by the claimant or by some person on his or her behalf. Page 1 , 1 Other: SILVANO B. MARCHESI COUNTY COUNSEL r� Deputy County Counsel CERTIFICATE OF SERVICE BY MAIL (C.C.P. §§ 1012, 1013x,2015.5;Evidence Code§§641,664) I declare that my business address is the County Counsel's Office of Contra Costa County,651 Pine Street,Martinez„California 94553;I am a citizen of the United States,over 18years of age,employed in Contra Costa County,and not a party to this action. I served a true copy of this Notice of Insufficiency and/or Non-acceptance of Claim by placing it in an envelope addressed as shown above,scaled and postage fully prepaid thereon,and thereafter was,deposited this day in the U.S.Mail at Martinez,California. I certify under penalty of perjury that the foregoing is true and correct. Dated: June 1' 2001,at Martinez,California. cc: Clerk of the Board of Supervisors(original) Risk Management (NOTICE OF INSUFFICIENCY OF CL.4LM:GOVT.CODE§§910,910.2,920.4,910.8) Page 2 _ h -... .. _ _ _ _ ._ _ ..t- .....�;. ..< ..i r... _ ..... .. - ......:.". 1II� i. 1, _ ::: r• ... y. .. \. 1 .. .. .. .... ._ . , , ... _., __ ... _ ,_ ... 91_ , ., , _. _.. .. .. _. .. .._. s. .,:...,... . _.. __.. "'.iia: :•i- n':�;: .,t r ..r .. ..,...-- .. .....:r .."-. ..,,_. . _. rr ._.... ... 7. .Yr'MR.,. �{y-:rte'•_.'.•:.'`. A\. -w :ZF ... .. _:..- - - ........ x .. .,... ,.... .. ..,- .,. _s. o ._ .. _:.. .a.. r .. .. ..e .. .... .. .. 1. r . .. ...:.,,. _ - - ,TCC'. r, d. .. .. .. .. _; .. ..... ... .��L _,., v �.,�:: ,. ,,_ - . w 7 -. r ,.::;: f `i�: ::: .. .... - c. D 1 _ i� - , .., .. . . ...- - a. _. . , _ a, - - - i_. F ,.,:.- 1 Jr .'; � •_,, ,,. . _ lJ _ _ r -.. .,r. ., ....r...., ., .. ......,., tw: o.. r _,..„.._.. .r. ., ._,. t , ...,... ,.a - _ ... t.: . �,..:.:;:,:: I.. 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On the date ofc tr 3�":� r�c 00C) I served the en V1\ ,re_.t.:J1"� _�� l/( ; �i'• ^�i ?f'�: �.� �'\.:. i -� , j��, 07ZI (esa t.title of document(s) served) by depositing a copy of the document(s) in the United States mail at (location) (city) Il'` tG 63. 's County, California in a sealed envelope, with postage fully prepaid, addressed as follows: (In the space below insert the name and mailing address of each person you are serving with these documents. If the person is a party to the action or an attorney for a party, indicate that with the address). C O O j - J �= ;,, t l �, c UC; JY1 n f fi ,1'1( -'. 1-= `i. �" _ )�\'' 1 i I Z G.. +;..j 'J `•�1(� t 1111. C r<:j �nCt.f 1 1�. L L=_1ZLy )Ci i't , iL L !�r•.. 1i (y�\C1.� i ? 7 _;,,_ _ l ( cj��j S ✓ 1 J r J � At the time of mailing there was regular delivery of united States mail between the place of deposit and the place of address. I declare under penalty of perjury under the Iaws of the State of California that the foregoing is true and correct.. Date: (Signature of person mailing) (Name of person mailing, typed or printed) 1 .J . r , ti Q �v �sa7 Ai c